The right ventricular outflow tract as an alternative permanent pacing site: long-term follow-up.
The long-term characteristics of the right ventricular outflow tract have been assessed as an alternative permanent pacing site to the right ventricular apex. Thirty-three consecutive patients requiring ventricular pacing were randomized to be paced from one of the two sites. Pacing was performed using a screw-in lead, and a programmable pacemaker was used to facilitate threshold testing. There was no significant difference in the lead positioning time or any acute implant measurement (e.g., threshold at 0.5 msec 0.4 +/- 0.2 V for both sites, P = 0.99). Chronic measurements were also comparable during follow-up (mean 73 months) with a mean threshold at most recent follow-up of 0.15 +/- 0.2 msec (apex) and 0.13 +/- 0.21 msec (outflow tract) at 5 V, P = 0.81. There was only one pacing related complication, a lead dislodgment (outflow tract) in a pacemaker twiddler. Overall, both sites were highly satisfactory.
Barin
E S
ES
Department of Cardiology, St. Bartholomew's Hospital, London, England.
Jones
S M
SM
Ward
D E
DE
Camm
A J
AJ
Nathan
A W
AW
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004553:Electric Conductivity; D015716:Electrocardiography, Ambulatory; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D010138:Pacemaker, Artificial