Transvenous Insertion of Double Sets of Permanent Electrodes

Abstract

ALTHOUGH less than 3% of pacemaker implants performed today make use of the atrium, now that new and stable atrial appendage electrodes are available and there is also a growing awareness of their physiological and clinical advantages, it seems likely that interest in atrial pacing will grow. This statement is corroborated (Michael Bilitch, MD; Seymour Furman, MD; Victor Parsonnet, MD: Four-year results of a National Pacemaker Registry, unpublished data, July 1974 to June 1978). Some enthusiasts estimate that the atrium will be used for various forms of pacing, eg, fixed rate atrial pacing (AOO); inhibitory atrial pacing (AAI); triggered atrial pacing (AAT); atrial synchronous pacing (VAT); and bifocal sequential demand pacing (DVI),¹in more than one half of the patients requiring pacemakers.^2,3 Unfortunately, the operation for implanting two electrodes can be difficult and time-consuming, because two separate veins must be identified and mobilized. We have usually used a