Transvenous Cardiac Pacing
- 1 October 1970
- journal article
- case report
- Published by Wolters Kluwer Health in Circulation
- Vol. 42 (4), 701-718
- https://doi.org/10.1161/01.cir.42.4.701
Abstract
Optimal electrode position for long-term transvenous cardiac pacing is in the apex of the right ventricle. Intracardiac electrograms, surface electrocardiograms, frontal fluoroscopy, lateral roentgenograms, and pacing threshold levels were studied in two groups of patients: One group was comprised of five patients with permanent pacemakers who had inadvertent malplacement of the pacing catheter, and the second group was composed of six patients undergoing temporary pacing from selected sites within the coronary venous system. The results of this study indicate that the appearance of a characteristic right ventricular endocardial complex recorded from the catheter tip is the most reliable guide to proper electrode placement. Low threshold levels, good position demonstrated roentgenographically, and typical surface electrocardiographic patterns of left bundle-branch block were all noted during intentional and following inadvertent malpositioning of the electrode within the coronary venous system and do not, therefore, guarantee proper positioning. A successful routine for pacemaker insertion has been established which includes fluoroscopy, lateral roentgenograms, intracardiac and surface electrocardiograms, and threshold analysis. Satisfaction of all these tests appears to insure proper electrode positioning.Keywords
This publication has 10 references indexed in Scilit:
- Perforation of the interventricular septum by transvenous pacemaker catheter: Diagnosis by change in pattern of depolarization on the electrocardiogram∗The American Journal of Cardiology, 1969
- Long-Term Pervenous Atrial Pacing From the Proximal Portion of the Coronary VeinJAMA, 1969
- An unusual site of ventricular pacing occurring during the use of the transvenous catheter pacemakerAmerican Heart Journal, 1969
- Malplacement of pacemaker catheters in the coronary sinusThe Journal of Thoracic and Cardiovascular Surgery, 1969
- Long-term electrode catheter pacing from coronary sinus.BMJ, 1968
- Left atrial rhythm: Diagnostic criteria and differentiation from nodal arrhythmiasThe American Journal of Cardiology, 1966
- Catheter Pacing in Complete Heart BlockPublished by American Medical Association (AMA) ,1965
- Variability of endocardial potentials of the right ventricle: Charles E. Kossmann, M.D., Adolph R. Berger, M.D., J. Brumlik, M.D., Stanley Briller, M.D., and Bertha Rader, M.D., New York, N. Y.American Heart Journal, 1949
- Studies in intracardiac electrography in manAmerican Heart Journal, 1949
- Endocardiac electrocardiogram obtained by heart catheterization in the manAmerican Heart Journal, 1947