title: The relationship between right ventricular lead position and paced QRS duration.
abstract: BACKGROUND
  The relationship between the anatomical location of right ventricular pacing site and paced QRS duration is unclear. In this study, we aimed to investigate the relationship between right ventricular pacing site and paced QRS duration using cardiac angiography.
  
  
  METHODS
  Fifty patients were implanted with pacemakers. The right ventricular lead position was determined from the findings of cardiac angiography and the paced QRS duration was measured. Cardiac angiography was used to display the right ventriculogram (RVG) and the left ventriculogram (LVG). The RVG view was divided into three areas and the LVG view was divided into four areas.
  
  
  RESULTS
  The paced QRS duration value was significantly longer in the right ventricular apex area compared with the outflow and inflow areas (160 ± 15 ms vs 140 ± 15 ms, P = 0.02, and vs 133 ± 17 ms, P < 0.001, respectively), but those values were not statistically significantly different between the right ventricular outflow and the right ventricular inflow areas (140 ± 15 ms vs 133 ± 17 ms, P = 0.187). When assessed with LVG views, there were the statistically significant differences in the paced QRS duration values in all areas except the apex area. (LV mid-anterior: 147 ± 11 ms vs LV base: 127 ± 13 ms, P < 0.001, and vs LV mid-septum: 129 ± 12 ms, P = 0.001, respectively.)
  
  
  CONCLUSIONS
  Cardiac angiography showed that there was a relationship between the anatomical right ventricular pacing site and paced QRS duration. Cardiac angiography can help determine the areas that produce shorter paced QRS duration.
authors.affiliation: Division of Cardiology, Ichinomiyanishi Hospital, Ichinomiya, Aichi, Japan. tkawakami-ind@umin.ac.jp
authors.forename: Tohru
authors.initials: T
authors.lastname: Kawakami
authors.forename: Nobukiyo
authors.initials: N
authors.lastname: Tanaka
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Ohno
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kobayakawa
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sakurai
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ishihara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ohmori
authors.forename: Terumasa
authors.initials: T
authors.lastname: Matsuzaki
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D005260:Female; D006329:Heart Conduction System / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000517:prevention & control; D006339:Heart Rate; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011859:Radiography; D016896:Treatment Outcome