title: Real-time three-dimensional echocardiographic determination of right ventricular outflow tract high septal pacing sites.
abstract: OBJECTIVE
  To investigate the feasibility of determination of right ventricular outflow tract (RVOT) high septal pacing site visualized by real-time three-dimensional echocardiography (RT3DE).
  
  
  METHODS
  The forty subjects with RVOT pacing were analysed. RT3DE determination of RVOT high septal pacing sites was compared with chest X-ray (CXR).
  
  
  RESULTS
  RVOT septal pacing sites could be obtained in all patients by RT3DE.When pacing sites were categorized as septal or non-septal, there were good agreements between echocardiography and CXR (kappa = 0.745). However, when RVOT pacing sites were categorized as high septal or non-high septal in identifying the exact anatomic location of pacing sites, there was only mild agreement between echocardiography and CXR (kappa = 0.275). Moreover, when RT3DE was used as the gold standard in identifying the exact anatomic location of RVOT, pacing at the RVOT high septal could only be achieved in 37.5% (n= 15) of patients using RT3DE, but in 65% (n= 26) using CXR, because the RVOT septal pacing lead tip found at high septal by CXR is actually found at low septal or free wall by RT3DE.
  
  
  CONCLUSIONS
  It is limited to accurately locate RVOT high septal pacing site only by CXR, RT3DE allows to determinate the RVOT high septal pacing sites helpfully.
authors.affiliation: Department of Echocardiography, Affiliated Jiangyin Hospital of South-East University Medical College, 163 Shou-Shan Road, Jiangyin, Jiangsu 214400, People' s Republic of China. gaochh@yahoo.com
authors.forename: Chun-Heng
authors.initials: CH
authors.lastname: Gao
authors.forename: Hua
authors.initials: H
authors.lastname: Zhang
authors.forename: Jun-You
authors.initials: JY
authors.lastname: Cui
authors.forename: Da-Zhong
authors.initials: DZ
authors.lastname: Zou
mesh_terms: D054537:Atrioventricular Block / Q000000981:diagnostic imaging* / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D058406:Cardiac Resynchronization Therapy; D016009:Chi-Square Distribution; D003199:Computer Systems; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D013223:Statistics as Topic; D013997:Time Factors