title: [Right ventricle pacing site optimization guided by intracardiac echocardiography].
abstract: Right ventricle outflow tract (RVOT) is an alternative pacing site to right ventricle apex (RVA). Intracardiac echocardiography (ICE) is a new method for intracardiac structures visualization.
  
  
  OBJECTIVE
  is comparison of functional effects of DDD permanent ventricular pacing in patients with lead implanted in RVA or in RVOT with the use of traditional fluoroscopy or in RVOT guided by ICE.
  
  
  METHODS
  33 patients with AV block grade I/III no older than 75 y (mean age 65,9+/-0,3 years). Group 1: 10 patients with RVA lead implantation. Group II: 12 patients with leads implanted in RVOT with the use of ICE. Group IlI: 11 patients with lead positioned in RVOT with the use of fluoroscopy. High septum was established as an target pacing site for RVOT implantation. On 3 day and 3 months after implantation the following parameters were collected: VO2 max, 6-minute walking test distance, level of NT-proBNP. The comparison of relative changes was done, 3 month vs. 3 day for each parameter.
  
  
  RESULTS
  Statistically significant greater decrease in NT-proBNP was found in Group II in comparison with both Group I and Ill (respectively p = 0.021 and p _ 0.034). Significantly greater increase in VO2 max was detected in patients Group II comparing to Group I (p = 0.047). Moreover it was found that ICE guided implantation is most effective in precise lead positioning.
  
  
  CONCLUSIONS
  ICE guided lead localization on high interventricular septum seems to have better functional characteristics than other right ventricle pacing sites.
authors.affiliation: Uniwersytet Medyczny w łodzi, Klinika Kardiologii Interwencyjnej, Kardiodiabetologii i Rehabilitacji Kardiologicznej, I Katedry Kardiologii, i Kardiochirurgii. kardiolog@skwam.lodz.pl
authors.forename: Leszek
authors.initials: L
authors.lastname: Markuszewski
authors.forename: Marcin
authors.initials: M
authors.lastname: Rosiak
authors.forename: Tomasz
authors.initials: T
authors.lastname: Grycewicz
authors.forename: Dariusz
authors.initials: D
authors.lastname: Michałkiewicz
authors.forename: Andrzej
authors.initials: A
authors.lastname: Cwetsch
authors.forename: Michał
authors.initials: M
authors.lastname: Chudzik
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D017147:Defibrillators, Implantable; D019160:Endosonography / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D016896:Treatment Outcome