To the Editor: Optimizing right ventricular lead position for defibrillation

Heart Rhythm ◽  
2012 ◽  
Vol 9 (12) ◽  
pp. e26-e27
Author(s):  
Carl R. Reynolds ◽  
Michael R. Gold
Keyword(s):  
Right Ventricular ◽  
Lead Position ◽  
Ventricular Lead

scholarly journals Optimization of right ventricular lead position in cardiac resynchronisation therapy☆

2006 ◽  
Vol 8 (6) ◽  
pp. 609-614 ◽  
Author(s):  
Lucie Riedlbauchová ◽  
Robert Ĉihaák ◽  
Jan Byteŝník ◽  
Vlastimil Vanĉura ◽  
Petr Frídl ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Cardiac Resynchronisation Therapy ◽  
Lead Position ◽  
Ventricular Lead ◽  
Cardiac Resynchronisation ◽  
Resynchronisation Therapy

Impact of the Right Ventricular Lead Position on Clinical End Points in CRT Recipients-A Subanalysis of the Multicenter Randomized SPICE Trial

2016 ◽  
Vol 39 (3) ◽  
pp. 261-267 ◽  
Author(s):  
STEFAN ASBACH ◽  
CARSTEN LENNERZ ◽  
VERENA SEMMLER ◽  
CHRISTIAN GREBMER ◽  
ULRICH SOLZBACH ◽  
...  
Keyword(s):  
Right Ventricular ◽  
End Points ◽  
Lead Position ◽  
Ventricular Lead ◽  
The Right

Impact of the right ventricular lead position on clinical outcome and on the incidence of ventricular tachyarrhythmias in patients with CRT-D

Heart Rhythm ◽  
2013 ◽  
Vol 10 (12) ◽  
pp. 1770-1777 ◽  
Author(s):  
Valentina Kutyifa ◽  
Poul Erik Bloch Thomsen ◽  
David T. Huang ◽  
Spencer Rosero ◽  
Christine Tompkins ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Right Ventricular ◽  
Ventricular Tachyarrhythmias ◽  
Lead Position ◽  
Ventricular Lead ◽  
The Right

139 How important is the right ventricular lead position in patients undergoing cardiac resynchronisation therapy?

Heart ◽  
2010 ◽  
Vol 96 (Suppl 1) ◽  
pp. A80.2-A80
Author(s):  
F Z Khan ◽  
P Salahshouri ◽  
M S Virdee ◽  
P A Read ◽  
M Elsik ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Cardiac Resynchronisation Therapy ◽  
Lead Position ◽  
Ventricular Lead ◽  
Cardiac Resynchronisation ◽  
Resynchronisation Therapy ◽  
The Right

The Relationship between Right Ventricular Lead Position and Paced QRS Duration

2012 ◽  
Vol 36 (2) ◽  
pp. 187-193 ◽  
Author(s):  
TOHRU KAWAKAMI ◽  
NOBUKIYO TANAKA ◽  
HIROYOSHI OHNO ◽  
HIROKO KOBAYAKAWA ◽  
TOMOHIRO SAKURAI ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Lead Position ◽  
Ventricular Lead ◽  
Qrs Duration ◽  
The Relationship

scholarly journals Association between right ventricular lead position and clinical outcomes in patients with cardiac resynchronization therapy

EP Europace ◽  
2017 ◽  
Vol 20 (4) ◽  
pp. 629-635 ◽  
Author(s):  
Mads Brix Kronborg ◽  
Jens Brock Johansen ◽  
Sam Riahi ◽  
Helen Hoegh Petersen ◽  
Jens Haarbo ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Right Ventricular ◽  
Clinical Outcomes ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Lead Position ◽  
Ventricular Lead

Abstract 12776: Long Term Mortality With Right Ventricular Apical Versus Septal Pacing

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Chance M Witt ◽  
Charles J Lenz ◽  
Henry H Shih ◽  
Elisa Ebrille ◽  
Andrew N Rosenbaum ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Pacemaker Implantation ◽  
Dual Chamber ◽  
Dual Chamber Pacemaker ◽  
Lead Position ◽  
Ventricular Lead ◽  
Significant Difference ◽  
Long Term Mortality

Introduction: Right ventricular apical (RVA) pacing appears to have detrimental effects on cardiac function and long term outcomes. Right ventricular non-apical (RVNA) pacing, especially in the septal position, has been postulated as an alternative that may lead to less morbidity and mortality. Prior studies have shown conflicting results and been limited by small numbers and short follow-up. We aimed to determine if right ventricular septal lead position was associated with a reduction in long-term mortality compared to RVA lead position. Methods: Patients who underwent dual-chamber pacemaker implantation from 2004 through 2013 were evaluated for right ventricular lead position based on chest radiographs. Lead positions were divided in to apical or non-apical. Non-apical lead positions were subdivided to isolate a septal lead position group. Mortality was compared between these groups. Results: During the study period, 3456 patients underwent dual-chamber pacemaker placement and had images appropriate for lead position evaluation. The group was 53.5% male with a mean age of 74 ± 13 years. RVNA lead position was found in 976 (28.2%) patients, including 243 (7.0%) with a septal position. There was no significant difference in age or prior heart failure diagnosis between groups. Kaplan-Meier survival analysis did not reveal a significant difference in mortality between patients with RVA versus RVNA lead position during 5 year follow-up (p = 0.82). However, septal lead position was associated with a significantly lower mortality compared with RVA position (p = 0.03) (figure). Conclusions: Right ventricular septal lead position is associated with a lower long-term mortality than RVA lead position. This has substantial implications regarding the preferred site for ventricular pacing lead placement.

Can Right Ventricular Lead Position Influence Paced QRS Duration in Patients with Abnormal and Normal Left Ventricular Function?

2017 ◽  
Author(s):  
Melissa Moey
Keyword(s):  
Right Ventricular ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Valuable Insight ◽  
Ventricular Ejection Fraction ◽  
Lead Position ◽  
Lead Placement ◽  
Ventricular Lead ◽  
Qrs Duration

Right ventricular apical pacing (RVAP) in pacemaker or implantable cardioverter‐defibrillator (ICD) therapy has been associated with the development and exacerbation of heart failure (HF). Studies have suggested that RVAP resulting in dyssynchronous left ventricular (LV) activation and prolonged QRS duration leads to progressive mechanical dysfunction, decreased systolic function and increased mortality. These data suggest that the effect may be most pronounced in patients with pre‐existing LV systolic dysfunction. Pacing at the RV septum however has demonstrated narrower paced QRS durations and is being considered as an alternative pacing site to the RVA. In this study, the effect of RV lead placement on the QRS duration in patients with LV systolic dysfunction who demonstrate a left ventricular ejection fraction (LVEF) < 35% and normal LVEF was compared.  Patients of a minimum age of 18 years with LVEF ≥ 50% (normal cohort) and LVEF ≤ 30% (HF cohort) were recruited. Four 3 minute high resolution recordings were obtained from an orthogonal lead position for subsequent offline signal averaging. Recordings of native rhythm and pacing at three RV sites: right ventricular outflow tract (RVOT), mid‐septum and RV apex (RVA) were obtained. A 12‐lead electrocardiogram (ECG) recording at each pacing site was stored for later confirmation of pacing location and comparison with paced averaged QRS duration. The QRS duration at different RV sites in the two populations was then compared.  As studies to date are limited, this study provided valuable insight on RV lead placement on QRS duration in device therapy for HF treatment.  

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