Implantation of Lumenless Pacing Leads at the Inter-atrial Septum and Right Ventricular Outflow Tract with Deflectable Catheter-sheath
- Author:
BAI RONG
1
,
2
;
KAM RUTH
;
CHING Keong CHI
;
HSU Fern LI
;
TEO Siong WEE
Author Information
1. Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology,Wuhan430030,China
2. Department of Cardiology, National Heart Centre, Singapore 168752, Singapore
- Keywords:
selective site pacing;
lumenless lead;
inter-atrial septum;
right ventricular outflow tract
- From:
Journal of Huazhong University of Science and Technology (Medical Sciences)
2008;28(6):639-644
- CountryChina
- Language:Chinese
-
Abstract:
Current permanent fight ventricular and fight atrial endocardial pacing leads are implanted utilizing a central lumen stylet. Right ventricular apex pacing initiates an abnormal asyno chronous electrical activation pattern, which results in asynchronous ventricular contraction and re-laxation. When pacing from right atrial appendage, the conduction time between two atria will be prolonged, which results in heterogeneity for both depolarization and repolarization. Six patients with Class Ⅰ indication for permanent pacing were implanted with either single chamber or dual chamber pacemaker. The SelectSecure 3830 4-French (Fr) lumenless lead and the SelectSite C304 8.5-Fr steerable catheter-sheath (Medtronic Inc., USA) were used. Pre-selected pacing sites included inter-atrial septum and right ventricular outflow tract, which were defined by ECG and fluoroscopic criteria. All the implanting procedures were successful without complication. Testing results (mean atrial pacing threshold: 0.87 V; mean P wave amplitude: 2.28 mV; mean ventricular pacing threshold:0.53V; mean R wave amplitude: 8.75 mV) were satisfactory. It is concluded that implantation of a 4-Fr lumenless pacing lead by using a streerable catheter-sheath to achieve inter-atrial septum or right ventricular outflow tract pacing is safe and feasible.
