Cardiac Pacing pp 331-334 | Cite as

Ventricular Lead in Atrial Position

  • Lukas Kappenberger
  • I. Babotai
  • F. Siclari
  • L. Egloff
  • M. Turina
Conference paper

Summary

Longterm function and stability of atrial leads is still a crucial part of dual chamber pacing and sensing. The use of the same type of electrode in the atrium and in the ventricle is an advantage and simplification from technical, surgical and logistic standpoints. We report about the results in 158 consecutive Helifix electrodes in atrial position and 143 Helifix electrodes in ventricular position in the same patients. The 158 patients (85 males, 43 females, mean age 63.5) received a pacemaker system with only atrial sensing (VAT of VDD) in 31%, with atrial pacing and sensing (AAI or DDD) in 44% and with atrial pacing but ventricular sensing only (DVI) in 25%. Electrodes were transvenously inserted via cephalic or subclavian vein. Atrial electrodes were placed underneath the crista terminalis of the lateral right atrium and not in the atrial appendage, the ventricular leads in the right ventricular apex. Atrial threshold at impulse duration of 1.0 ms was 0.85 V (0.37–2.04) and 1.11 rnA (0.4–2.0), P-wave was 3.21 mV (1.0–9.5). Ventricular threshold at 1.0 was 0.67 V (0.25–1.70) and 0.89 mA (0.25–2.1), R-wave was 7.9 mV (1.3–20.0). After mean follow-up of 18.2 months overall complication rate was 3%. 3 early displacements (2 within 24 hours and I after 3 months). We observed one case of phrenic nerve stimulation. From these results we conclude that an electrode primarily designed for ventricular use is extremely suitable for longterm atrial sensing and stimulation and overall complication is not increased in dual chamber pacing.

Keywords

Kelly Zucker Culi 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Lagergren H, Johansson L, Karlöf I, Thornander H: Atrial-triggered pacemaking without thoracotomy: apparatus and results in twenty cases. Acta Chir Scand 1966; 132: 678.Google Scholar
  2. 2.
    Zucker IR, Parsonnet V, Gilbert L: A method of permanent transvenous implantation of an atrial electrode. Amer Heart J 1973; 85: 195.CrossRefPubMedGoogle Scholar
  3. 3.
    Smyth NPD, Citron P, Keshishian JM, Garcia JM, Kelly LC: Permanent pervenous atrial sensing and pacing with a new J-shaped lead. J tho rae cardiovasc Surg 1976; 72: 565.Google Scholar
  4. 4.
    Kappenberger L, Babotai I, Turina M: Modified positioning of Helifix transvenous atrial electrodes. Cardiac Pacing, GA Feruglio (ed), pp 649–651. Piccin Medical Books 1982.Google Scholar
  5. 5.
    Bergdahl L: Helifix, an electrode suitable for transvenous atrial and ventricular implantation. J thorac cardiovasc Surg 1980; 80: 794.PubMedGoogle Scholar
  6. 6.
    Kappenberger L, Münch U, Babotai I, Baumann PC, Steinbrunn W, Turina M: Technik und Langzeitresultate der Schrittmacherbehandlung mit Vorhofelektroden. Schweiz med Wschr 1981; 111: 1706.PubMedGoogle Scholar
  7. 7.
    Babotai I, Meier WE: Erste klinische Erfahrungen mit der neuen intrakardialen Elektrode “Helifix”. Schweiz med Wschr 1977; 107: 1592.PubMedGoogle Scholar
  8. 8.
    Levine PA, Brodsky SJ, Seltzer JB: The ventricular tined lead in atrial pacing, an alternative to the preformed J lead. Pace 1983; 6: A-71.Google Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt 1983

Authors and Affiliations

  • Lukas Kappenberger
    • 1
  • I. Babotai
  • F. Siclari
  • L. Egloff
  • M. Turina
  1. 1.Dept. of MedicineUniversity HospitalZürich/SchweizSwitzerland

Personalised recommendations