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https://hdl.handle.net/2440/39110
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Type: | Journal article |
Title: | The challenge of endocardial right ventricular pacing in patients with a tricuspid annuloplasty ring and severe tricuspid regurgitation |
Author: | Kistler, P. Sanders, P. Davidson, N. Mond, H. |
Citation: | Pacing and Clinical Electrophysiology, 2002; 25(2):201-205 |
Publisher: | Futura Publ Co |
Issue Date: | 2002 |
ISSN: | 0147-8389 1540-8159 |
Statement of Responsibility: | Peter M. Kistler, Prashanthan Sanders, Neil C. Davidson, and Harry G. Mond |
Abstract: | On occasion, patients with a tricuspid annuloplasty ring may require permanent cardiac pacing. Although it is technically possible to pass a ventricular transvenous lead through a tricuspid valve with an annuloplasty ring, the procedure is complicated by considerable chamber enlargement and mechanical distortion of the tricuspid valve often with severe residual tricuspid regurgitation. Over a 25-month period, transvenous ventricular lead placement following insertion of a tricuspid annuloplasty ring was successfully performed in five patients (three women). The patient mean age was 66 years (range 55-77 years). Four cases had slow atrial fibrillation and another paroxysmal atrial fibrillation requiring His-bundle ablation. Two patients had mitral valve replacement and two aortic and mitral valve replacements. All patients had residual severe to torrential tricuspid regurgitation. Seven ventricular steroid-eluting screw-in leads were used. Single leads were used in three cases, whereas in two others, two ventricular leads were attached to a dual chamber pulse generator. Although technically difficult, ventricular lead placement was successful using standard guidewires with broad curvatures. Satisfactory acute and follow-up stimulation thresholds and sensing were obtained with the only complication being an intraoperative lead dislodgement, prompting a second ventricular lead. Successful transvenous lead placement across a tricuspid annuloplasty ring is possible. |
Keywords: | ventricular pacing tricuspid annuloplasty |
Description: | © 2002 by Futura Publishing Company, Inc. |
DOI: | 10.1046/j.1460-9592.2002.00201.x |
Published version: | http://www.blackwell-synergy.com/doi/abs/10.1046/j.1460-9592.2002.00201.x |
Appears in Collections: | Aurora harvest 6 Medicine publications |
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