PERFORATION OF THE RIGHT ATRIUM WITH THE DEVELOPMENT OF RIGHT-SIDED PNEUMOTHORAX AND PNEUMOPERICARDIUM IN A PATIENT WITH AN IMPLANTED DUAL-CHAMBER PACEMAKER

Objective. The aim of the study was to compare the two approaches to chronic right ventricular pacing currently adopted in clinical practice: right ventricular apical (RVA) and non-RVA pacing. Background. Chronic RVA pacing is associated with an increased risk of atrial fibrillation, morbidity, and even mortality. Non-RVA pacing may yield more physiologic ventricular activation and provide potential long-term benefits and has recently been adopted as standard procedure at many implanting centers. Methods. The Right Pace study was a multicenter, prospective, single-blind, nonrandomized trial involving 437 patients indicated for dual-chamber pacemaker implantation with a high percentage of RV pacing. Results. RV lead-tip target location was the apex or the interventricular septum. RVA (274) and non-RVA patients (163) did not differ in baseline characteristics. During a median follow-up of 19 months (25th–75th percentiles, 13–25), 17 patients died. The rates of the primary outcome of death due to any cause or hospitalization for heart failure were comparable between the groups (log-rank test, p=0.609), as were the rates of the composite of death due to any cause, hospitalization for heart failure, or an increase in left ventricular end-systolic volume ≥ 15% as compared with the baseline evaluation (secondary outcome, p=0.703). After central adjudication of X-rays, comparison between adjudicated RVA (239 patients) and non-RVA (170 patients) confirmed the absence of difference in the rates of primary (p=0.402) and secondary (p=0.941) outcome. Conclusions. In patients with indications for dual-chamber pacemaker who require a high percentage of ventricular stimulation, RVA or non-RVA pacing resulted in comparable outcomes. This study is registered with ClinicalTrials.gov (identifier: NCT01647490).

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Accidental Transarterial Implantation of Dual Chamber Pacemaker Leads in the Left Ventricle and the Right Coronary Artery

Pacing and Clinical Electrophysiology ◽

10.1111/j.1540-8159.2005.50015.x ◽

2005 ◽

Vol 28 (5) ◽

pp. 469-471 ◽

Cited By ~ 2

Author(s):

MATTHIAS OVERBECK ◽

CHRISTOF KOLB ◽

CLAUS SCHMITT ◽

ALBERT SCHOMIG ◽

RUDIGER LANGE

Keyword(s):

Coronary Artery ◽

Left Ventricle ◽

Right Coronary Artery ◽

Dual Chamber ◽

Dual Chamber Pacemaker ◽

Pacemaker Leads ◽

The Right

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Myocardial biomechanics, intracardiac hemodynamics and endothelial function in patients before and after various types of pacemakers implantation

Cardiosomatics ◽

10.26442/22217185.2019.2.190307 ◽

2019 ◽

Vol 10 (2) ◽

pp. 56-63

Author(s):

Viktoriia A. Sanakoyeva ◽

Maksim S. Rybachenko ◽

Alena A. Pukhayeva ◽

Aleksandr G. Avtandilov

Keyword(s):

Endothelial Function ◽

Right Ventricle ◽

Acute Hypoxia ◽

Small Sample ◽

Lv Function ◽

Dual Chamber ◽

Dual Chamber Pacemaker ◽

Ventricular Stimulation ◽

The Right ◽

Stimulation Of

This review presents 31 sources from 1995 to 2019. Atrioventricular blockades (AVB) 2-3 degrees occupy a special place among the causes of death from cardiovascular disease. The above AVB lead to a significant slowing of the heart rate and predispose to the development and progression of heart failure (HF) and the occurrence of acute hypoxia of the brain and attacks Morgagni-Adams-Stokes. The main method of treatment of hemodynamically significant AB-conduction disorders is electrocardiostimulation (ES), which is the basic method of treatment. A single chamber pacemaker is the most often implanted with using isolated ventricular stimulation in clinical practice in the Russian Federation. Implantation of a dual chamber pacemaker is less frequent. This type of stimulation allows to maintain atrioventricular synchronization constantly. Stimulation of the apex of the right ventricle leads to a decrease in left ventricle (LV) function and structural changes that are a consequence of the occurrence of electric and mechanical dyssynchrony of the myocardium. There is a large number of works devoted to the comparison of different methods of ES leading to the conclusion that a powerful alternative to the stimulation of the apex of the right ventricle can be a dual ventricular stimulation. It is noted that implantation of single-and dual-chamber pacemaker with fixation of the electrode in the region of the right ventricle apex leads to the fact that both modes of stimulation can not cancel the electrical and anatomical remodeling of the myocardium of left atrium and LV. It may be necessary to use a more physiological site of stimulation with using optimal AB-delay to minimize the frequency of ventricular stimulation. Endothelium plays an important and independent role in the development of cardiovascular diseases. The effect of AB conduction impairment on endothelial function (EF) has not been described to date. There were few studies which are discussed the influence of constant pacemaker on endothelial function in patients with AVB 2-3 degrees in recent years. It should be noted that the studies were conducted on a small sample of patients and had a different design.

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Dual-chamber pacemaker implantation through a persistent left superior vena cava with remaining connection to the right superior vena cava

Acta Cardiologica ◽

10.1080/ac.69.2.3017311 ◽

2014 ◽

Vol 69 (2) ◽

pp. 220-221

Author(s):

Christophe Garweg ◽

David Derthoo ◽

Rik Willems

Keyword(s):

Superior Vena Cava ◽

Superior Vena ◽

Pacemaker Implantation ◽

Vena Cava ◽

Dual Chamber ◽

Left Superior Vena Cava ◽

Dual Chamber Pacemaker ◽

Persistent Left Superior Vena ◽

The Right

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Intermittent capture of the right ventricular outflow tract by atrial pacing in a patient with a dual-chamber pacemaker

Journal of Electrocardiology ◽

10.1016/j.jelectrocard.2012.06.018 ◽

2012 ◽

Vol 45 (6) ◽

pp. 787-789 ◽

Cited By ~ 3

Author(s):

Julio Daniel Pastori ◽

Hugo Ariel Garro ◽

Adrián Baranchuk ◽

Pablo Ambrosio Chiale

Keyword(s):

Right Ventricular ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Outflow Tract ◽

Atrial Pacing ◽

Dual Chamber ◽

Dual Chamber Pacemaker ◽

The Right

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Pacemaker implantation using electroanatomical mapping system Carto 3: technical protocol, single centre experience

EP Europace ◽

10.1093/europace/euab116.384 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

J Elices Teja ◽

O Duran Bobin ◽

A Lopez Lopez ◽

A Perez Perez ◽

R Franco Gutierrez ◽

...

Keyword(s):

Right Ventricle ◽

Pacemaker Implantation ◽

Three Dimensional ◽

Venous Access ◽

Dual Chamber ◽

Dual Chamber Pacemaker ◽

Funding Sources ◽

Vein Access ◽

Area Product ◽

The Right

Abstract Funding Acknowledgements Type of funding sources: None. Background / Purpose: Three-dimensional electro-anatomical mapping systems (EAM) reduce fluoroscopy exposure during ablation procedures. The aim of this study is to evaluate the security and feasibility of performing pacemaker implantation with EAM routinely on a more regular basis (without fluoroscopy) and to draft a technical protocol to perform these implants. Methods Eight non-selected patients with pacemaker indication that had been referred to the electrophysiology unit of our institution underwent a dual chamber pacemaker implantation with EAM system Carto 3 (Biosense Webster, Irvine, CA, USA). All implants were performed by the same operator and, in all cases, the same lead model was employed. All difficulties that arose during the implantations were solved applying the actions contained in the protocol described below. First - Creation of three anatomical maps with Carto 3: venous access, right atrium and right ventricle. Annotate the end of the venous sheath. Second- For right ventricle lead positioning, connect the pacemaker lead to the Carto 3 system as an external catheter. Place the right ventricle lead, fix it and perform measurements. Third - Fuse the three maps with the "anatomical merge" tool. Fourth - Using the "design line" tool, draw a line from the tip of the lead to the end of the venous sheath following the expected trajectory of the lead in its correct position. Measure that distance. Calculate (substrate) the theoretically remaining lead. Fifth - With a ruler, measure the portion of the lead remaining out of the sheath. Sixth - Reposition the lead, if necessary. Seventh - Repeat the same procedure for the atrial lead and complete the implant procedure. Finally - Verify leads position with fluoroscopy (optional). Results : Eight patients received a dual chamber pacemaker, 75% male with a mean age 82,88 ±4,97 years. The most frequent indication was AV block (75%). The implant was performed through cephalic vein access (37,5%), subclavian vein access (50%). Mean procedure time (skin to skin) was 94 ±15 minutes. There were no complications related to the implant nor was it necessary to replace the lead. Conclusions : Pacemaker implantation with Carto 3 is a safe and reliable. The learning curve is not steep and the operator should be confident enough only after a few procedures. The protocol developed facilitates the implant procedure. Fluoroscopy timeCase12345678Fluoroscopy time (s)474786246060Dose area product (Gy*cm2)4,270,3710,0290,0630,0630,020,1230,018Abstract Figure. Carto image: dual chamber pacemaker.

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