Novel Technique of Dual Chamber Pacing Through Minithoracotomy and Transatrial Endocardial Active Fixation Lead Insertion for Epicardial Pacing Lead Malfunction

Sivakumar, Kothandam; Coelho, Robert

doi:10.1016/s0972-6292(16)30668-4

Cited by 6 publications

(5 citation statements)

References 3 publications

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“…When superior vena cava is occluded following Senning or Mustard surgery, stenting of the vein provides the access for an endocardial lead [32]. Hybrid peratrial approach described in section 2.2 has also been advocated in such patients [33,34]. Peratrial approach is safe, less morbid, offers low pacing threshold and can be applied widely with few contraindications.…”

Section: Discussionmentioning

confidence: 99%

“…Peratrial approach is safe, less morbid, offers low pacing threshold and can be applied widely with few contraindications. Peratrial lead placement has the additional advantage to allow somatic growth by creating a smaller redundant atrial lead loop [34]. Venous collaterals representing remnants of persistent left superior vena cava may develop after Fontan surgery and allow access to the coronary sinus.…”

Section: Discussionmentioning

confidence: 99%

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Endocardial transvenous pacing in patients with surgically palliated univentricular hearts: A review on different techniques, problems and management

Umamaheshwar

Singh

Sivakumar

2019

Indian Pacing and Electrophysiology Journal

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Fontan surgery and its modifications have improved survival in various forms of univentricular hearts. A regular atrial rhythm with atrioventricular synchrony is one of the most important prerequisite for the long-term effective functioning of this preload dependent circulation. A significant proportion of these survivors need various forms of pacing for bradyarrhythmias, often due to sinus nodal dysfunction and sometimes due to atrioventricular nodal block. The diversion of the venous flows away from the cardiac chambers following this surgery takes away the simpler endocardial pacing options through the superior vena cava. The added risks of thromboembolism associated with endocardial leads in systemic ventricles have made epicardial pacing as the procedure of choice. However challenges in epicardial pacing include surgical adhesions, increased pacing thresholds leading to early battery depletion and frequent lead fractures. When epicardial pacing fails, endocardial lead placement is equally challenging due to lack of access to the cardiac chambers in Fontan circulation. This review discusses the univentricular heart morphologies that may warrant pacing, issues about epicardial pacing, different techniques for endocardial pacing in patients with disconnected superior vena cava, pacing in different modifications of Fontan surgeries, issues of systemic thromboembolism with endocardial leads, atrioventricular valve regurgitation attributed to pacing leads and device infections. In a vast majority of patients following Glenn shunt and Senning surgery, an epicardial pacing and lead replacement is always feasible though technically very difficult. This article highlights the different options of transatrial and transventricular endocardial pacing.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endocardial transvenous pacing in patients with surgically palliated univentricular hearts: A review on different techniques, problems and management

Umamaheshwar

Singh

Sivakumar

2019

Indian Pacing and Electrophysiology Journal

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“…Epicardial lead option was also ruled out owing to their complication rates and non MRI compatibility. Transatrial lead placement was also not indicated [ 10 , 11 ]. Cardiopulmonary bypass was not used in this case.…”

Section: Case Reportmentioning

confidence: 99%

Alternate method for endocardial pacemaker lead implantation: A hybrid mini-thoracotomy approach

Kumar

Nayak

Yadav

et al. 2021

Indian Pacing and Electrophysiology Journal

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Although the conventional methods for endo-cardial pacemaker lead implantation via subclavian or cephalic or axillary vein routes is common, but sometimes due to anatomical variations it is not feasible to access these veins Emergence of newer techniques are useful for lead implantation. This case report focuses on a hybrid approach of combined mini-thoracotomy for endocardial pacemaker lead implantation. This fluoroscopy guided minimal thoracotomy approach with endocardial MRI compatible lead placement had the benefits of simple procedural, minimal hospital stay, low early complication rates and economically viable to the patient.

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“…This result was difficult to analyze owing to the small number of cases (n ¼ 12) and different techniques that were used in performing TML-V (transatrial or transventricular). Literature on TML-V placement exists only as small series or case reports without long-term follow-up [12][13][14]. Kassai and colleagues [14] reported transapical placement of ventricular pacing leads for adult cardiac resynchronization therapy in 20 patients.…”

Section: Commentmentioning

confidence: 99%

Transmural Placement of Endocardial Pacing Leads in Patients With Congenital Heart Disease

Sandrio

Purbojo

Toka

et al. 2016

The Annals of Thoracic Surgery

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Novel Technique of Dual Chamber Pacing Through Minithoracotomy and Transatrial Endocardial Active Fixation Lead Insertion for Epicardial Pacing Lead Malfunction

Cited by 6 publications

References 3 publications

Endocardial transvenous pacing in patients with surgically palliated univentricular hearts: A review on different techniques, problems and management

Endocardial transvenous pacing in patients with surgically palliated univentricular hearts: A review on different techniques, problems and management

Alternate method for endocardial pacemaker lead implantation: A hybrid mini-thoracotomy approach

Transmural Placement of Endocardial Pacing Leads in Patients With Congenital Heart Disease

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