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2000 | 59 | 4 |

Tytuł artykułu

The localisation of the electrode in permanently paced heart - an echocardiographical study

Warianty tytułu

Języki publikacji

EN

Abstrakty

EN
Permanent cardiac pacing is a widely applied procedure in invasive cardiology. The aim of our study was the analysis of the localisation of the tip of the pacemaker lead and its course in the right ventricle. Research was carried out on a group of 12 patients (5F, 7M), from 40 to 93 years of age (average 70±15 yrs) with permanent cardiac pacing or implantable cardioverter-defibrillator (ICD). Subsequent echocardiographic views were applied: an apical four chamber view, a subcostal one and a parasternal right ventricular inflow tract view. At the level of the tricuspid annulus the electrode was positioned: the anterior leaflet – 41.7% (5 pts), the anteroseptal commissure 25% (3 pts), the posterior leaflet 8.3% (1 pt) and the septal one – 8.3% (1 pt). In 16.7% (2 patients) the lead was positioned centrally in the right atrioventricular orifice. Regarding the further positioning of the electrode in the ventricle, in 41.7% (5 pts) the leads were placed along the interventricular septum, in 16.7% (2 pts) along the anterior wall of right ventricle and in 41.7% (5 pts) across the centre of the right ventricle. The tip of the lead was positioned in the apex of the right ventricle in 83.4% (10 pts). In the remaining 16.7% (2 pts) the position was not apical — in 1 patient the anterior wall of the right ventricle and in 1 patient the interventricular septum. In the VVI pacing mode the electrode did not lie on the interventricular septum. In contrast to this in 80% of patients (4 pts) having the DDD pacing mode the lead was situated on the interventricular septum on its course downwards to the ventricle. Conclusions: 1) On the level of the leaflets of the tricuspid valve the lead most often was positioned at the level of the anterior leaflet and the anteroseptal commissure. 2) Most patients had an apical localisation of the tip of the lead. 3) Differences between morphological and echocardiographic studies are related to the intravital and the two-dimensional character of echocardiography, and probably to the small population of the group examined.

Wydawca

-

Czasopismo

Rocznik

Tom

59

Numer

4

Opis fizyczny

p.311-315,fig.

Twórcy

autor
  • Medical University of Gdansk, Kieturakisa 1, 80-742 Gdansk, Poland
autor
autor
autor

Bibliografia

  • 1. Alonso C, Leclercq C, Victor F, Mansour H, de Place C, Pavin D, Carre F, Mabo P, Daubert JC (1999) Electrocardiographic predictive factors of long-term clinical improvement with multisite biventricular pacing in advanced heart failure. Am J Cardiol, 84: 1417–1421.
  • 2. Barin ES, Jones SM, Ward DE, Camm AJ, Nathan AW (1991) The right ventricular outflow tract as an alternative permanent pacing site: long-term follow-up. Pacing Clin Electrophysiol, 14: 3–6.
  • 3. Brinker J., Midei M (1996) Techniques of pacemaker implantation. In: Ellenbogen KA (ed.) Cardiac pacing. Blackwell Science, pp. 216–277.
  • 4. Candinas R, Duru F, Schneider J, Luscher TM, Stockes K (1999) Postmortem analysis of encapsulation around long-term ventricular endocardial pacing leads. Mayo Clin Proc, 74: 120–125.
  • 5. Cazeau S, Ritter P, Bakdach S, Lazarus A, Limousin M, Henao L, Mundler O, Daubert JC, Mugica J (1994) Four chamber pacing in dilated cardiomyopathy. Pacing Clin Electrophysiol, 17: 1974–1979.
  • 6. Drinkovic N (1983) Subcostal 2D echocardiography in cardiac pacing and intracardiac electrophysiologic studies. Ultrasound Med Biol, Suppl 2: 293–297.
  • 7. Kaemmerer H, Kochs M, Hombach V (1993) Ultrasound-guided positioning of temporary pacing catheters and pulmonary artery catheters after echogenic marking. Clin Intensive Care, 4: 4–7.
  • 8. Kozłowski D, Dubaniewicz A, Koźluk E, Adamowicz M, Grzybiak M, Walczak E, Walczak F, Kosiński A, Woźniak P (1998) Morfologiczne aspekty jednojamowej prawokomorowej stałej stymulacji serca. Część I: Położenie elektrody w prawej komorze serca. ESS, 5: 38–44.
  • 9. Kozłowski D, Dubaniewicz A, Koźluk E, Adamowicz A, Grzybiak M, Walczak E (1997) Possible mechanism of the tricuspid insufficiency in the permanent right ventricular pacing. Morphological study. Proceedings of the 8th European Symposium on Cardiac Pacing. Athens, Greece, Monduzzi Editore, 99–101.
  • 10. Kozłowski D (1999) Morfologia łącza przedsionkowokomorowego w aspekcie powstawania zaburzeń przewodzenia i krążącego pobudzenia. Rozprawa habilitacyjna. Gdańsk.
  • 11. Kozłowski D, Dubaniewicz A, Koźluk E, Grzybiak M, Krupa W, Kołodziej P, Pazdyga A, Adamowicz-Kornacka M, Walczak E, Walczak F (2000) The morphological conditions of the permanent pacemaker lead extraction. Folia Morphol, 59: 25–29.
  • 12. Lee MS, Evans SJ, Blumberg S, Bodenheimer MM, Roth SL (1994) Echocardiographically guided electrophysiologic testing in pregnancy. J Am Soc Echocardiogr 7: 182–186.
  • 13. Meier B, Felner JM (1982) Two-dimensional echocardiographic evaluation of intracardiac transvenous pacemaker leads. J Clin Ultrasound 1982, 10: 421–425.
  • 14. Pierard L, El Allaf D, D’Orio V, Demoulin JC, Carlier J (1984) Two-dimensional echocardiographic guiding of endomyocardial biopsy. Chest, 85: 759–762.
  • 15. Schwartz C, Nicolosi R, Lapinsky R, Grodman R (1986) Use of two-dimensional echocardiography in detection of an aberrantly placed transvenous pacing catheter. Am J Med, 80: 133–138.
  • 16. Staniewicz J, Wilczek R, Świątecka G, Stanke A, Krzymińska-Stasiuk E, Baczyńska A, Krupa W (1998) Short versus long term results in right ventricular outflow tract pacing – prospective randomised study. Pacing Clin Electrophysiol, 21 (p. II): 419 (abstract).
  • 17. Świątecka G (ed.) (1999) Standardy postępowania w elektroterapii serca. Folia Cardiol. 1 (Supl. 1): 1–13.
  • 18. Tajik AJ, Seward JB, Hagler DJ, Mair DD, Lie JT (1978) Two-dimensional real-time ultrasonic imaging of the heart and great vessels. Technique, image orientation, structure, identification and validation. Mayo Clin. Proc. 53: 271–303.

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Bibliografia

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