Document Detail


Right ventricular septal pacing: the success of stylet-driven active-fixation leads.
MedLine Citation:
PMID:  19804487     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The detrimental effects of right ventricular (RV) apical pacing on left ventricular function has driven interest in alternative pacing sites and in particular the mid RV septum and RV outflow tract (RVOT). RV septal lead positioning can be successfully achieved with a specifically shaped stylet and confirmed by the left anterior oblique (LAO) fluoroscopic projection. Such a projection is neither always used nor available during pacemaker implantation. The aim of this study was to evaluate how effective is the stylet-driven technique in septal lead placement guided only by posterior-anterior (PA) fluoroscopic view. METHODS: One hundred consecutive patients with an indication for single- or dual-chamber pacing were enrolled. RV septal lead positioning was attempted in the PA projection only and confirmed by the LAO projection at the end of the procedure. RESULTS: The RV lead position was septal in 90% of the patients. This included mid RV in 56 and RVOT in 34 patients. There were no significant differences in the mean stimulation threshold, R-wave sensing, and lead impedance between the two sites.In the RVOT, 97% (34/35) of leads were placed on the septum, whereas in the mid RV the value was 89% (56/63). CONCLUSIONS: The study confirms that conventional active-fixation pacing leads can be successfully and safely deployed onto the RV septum using a purposely-shaped stylet guided only by the PA fluoroscopic projection.
Authors:
Raphael Rosso; Andrew W Teh; Caroline Medi; Thuy To Hung; Richard Balasubramaniam; Harry G Mond
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-05
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  33     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-05-06     Completed Date:  2010-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  49-53     Citation Subset:  IM    
Affiliation:
The Department of Cardiology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Pacing, Artificial / methods*
Female
Fluoroscopy
Heart Septum
Heart Ventricles
Humans
Male
Postoperative Complications
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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