Right ventricular outflow tract placement of defibrillation leads: five year experience

Over a 5-year period, 112 patients (89 male/23 female, mean age 65 years) underwent right ventricular outflow tract (RVOT) placement of permanent active-fixation transvenous pacing/defibrillating leads. At implantation, the pacing threshold was 0.6 +/- 0.3 V at 0.5 ms pulse duration and R wave ampli...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 2004-04, Vol.27 (4), p.443-446
Main Authors: Giudici, Michael C, Barold, S Serge, Paul, Deborah L, Schrumpf, Phillip E, Van Why, Kent J, Orias, David W
Format: Article
Language:English
Subjects:
Adult
Aged
Cardiac Pacing, Artificial - methods
Cardiomyopathies - therapy
Defibrillators, Implantable
Electric Countershock - methods
Electrocardiography
Female
Heart Ventricles
Humans
Male
Middle Aged
Pacemaker, Artificial
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Summary:Over a 5-year period, 112 patients (89 male/23 female, mean age 65 years) underwent right ventricular outflow tract (RVOT) placement of permanent active-fixation transvenous pacing/defibrillating leads. At implantation, the pacing threshold was 0.6 +/- 0.3 V at 0.5 ms pulse duration and R wave amplitude was 10.9 +/- 4.9 mV. The defibrillation threshold (DFT) of right-sided implants was 17.7 +/- 3.4 J while that of left-sided implants was 16.1 +/- 3.3 J. Patients were followed at 1 and 3 month postimplant and at six-month intervals thereafter. At mean follow-up of 22.5 +/- 17.5 months (range 1-47 months) there were no lead dislodgments, unsuccessful shock therapies, or failure to sense or pace for bradycardia or tachycardia. Death was not sudden in the 17 patients who died. We conclude that RVOT pacing-defibrillation lead implantation is safe, efficacious, and potentially attractive because preliminary evidence suggests that it may not be associated with the adverse hemodynamic effects of pacing at the right ventricular apex.
ISSN:0147-8389
1540-8159
DOI:10.1111/j.1540-8159.2004.00461.x