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- Title
Right Ventricular Septal Pacing: A Comparative Study of Outflow Tract and Mid Ventricular Sites.
- Authors
ROSSO, RAPHAEL; MEDI, CAROLINE; TEH, ANDREW W.; HUNG, THUY TO; FELDMAN, ALEXANDER; LEE, GEOFFREY; MOND, HARRY G.
- Abstract
Background: Prolonged right ventricle (RV) apical pacing is associated with left ventricle (LV) dysfunction due to dysynchronous ventricular activation and contraction. Alternative RV pacing sites with a narrower QRS compared to RV pacing might reflect a more physiological and synchronous LV activation. The purpose of this study was to compare the QRS morphology, duration, and suitability of RV outflow tract (RVOT) septal and mid-RV septal pacing. Methods: Seventeen consecutive patients with indication for dual-chamber pacing were enrolled in the study. Two standard 58-cm active fixation leads were passed to the RV and positioned in the RVOT septum and mid-RV septum using a commercially available septal stylet (model 4140, St. Jude Medical, St. Paul, MN, USA). QRS duration, morphology, and pacing parameters were compared at the two sites. The RV lead with less-satisfactory electrical parameters was withdrawn and deployed in the right atrium. Results: Successful positioning of the pacing leads at the RVOT septum and mid-RV septum was achieved in 15 patients (88.2%). There were no significant differences in the mean stimulation threshold, R-wave sensing, and lead impedance between the two sites. The QRS duration in the RVOT septum was 151 ± 14 ms and in the mid-RV septum 145 ± 13 ms (P = 0.150). Conclusions: This prospective observational study shows that septal pacing can be reliably achieved both in the RVOT and mid-RV with active fixation leads using a specifically shaped stylet. There are no preferences in regard to acute lead performance or paced QRS duration with either position. (PACE 2010; 33:1169-1173)
- Subjects
AUSTRALIA; HEART block; SICK sinus syndrome treatment; CARDIAC pacing; COMPARATIVE studies; FISHER exact test; RIGHT heart ventricle; HEART septum; LONGITUDINAL method; SCIENTIFIC observation; HEALTH outcome assessment; T-test (Statistics); TREATMENT effectiveness; DESCRIPTIVE statistics; THERAPEUTICS
- Publication
Pacing & Clinical Electrophysiology, 2010, Vol 33, Issue 10, p1169
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.2010.02836.x