The right ventricular outflow tract: the road to septal pacing.
BACKGROUND
Pacing from the right ventricular apex is associated with long-term adverse effects on left ventricular function. This has fuelled interest in alternative pacing sites, especially the septal aspect of the right ventricular outflow tract (RVOT). However, it is a common perception that septal RVOT pacing is difficult to achieve.


RESULTS
In this article, we will review the anatomy of the RVOT and discuss the importance of standard radiographic views and the 12-lead electrocardiogram in aiding lead placement. We will also describe a method utilizing a novel stylet shape, whereby a conventional active-fixation, stylet-driven lead can be easily and reliably deployed onto the RVOT septum.
Mond
Harry G
HG
Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Australia. hmond@bigpond.net.au
Hillock
Richard J
RJ
Stevenson
Irene H
IH
McGavigan
Andrew D
AD
D002304:Cardiac Pacing, Artificial / Q000379:methods* / Q000592:standards; D004562:Electrocardiography; D005471:Fluoroscopy; D006352:Heart Ventricles / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D015203:Reproducibility of Results