Ask an Expert

Please enter your login and password here

Send

Fellowship

Please enter your login and password here

Submit

Journal Scan

Inter and intravein differences in cardiac output with cardiac resynchronization pacing using a multipolar LVpacing lead


Pacing Clin Electrophysiol. 2015 Feb;38(2):267-74.

Inter and intravein differences in cardiac output with cardiac resynchronization pacing using a multipolar LVpacing lead.

Jones MA1Khiani RFoley PWebster DQureshi NWong KCRajappan KBashir YBetts TR.

BACKGROUND:

Quadripolar left ventricular pacing leads permit a variety of pacing configurations from different sites within a coronary vein. There may be advantages to selecting a specific pacing vector. This study examines whether the range of cardiac outputs obtained at cardiacresynchronization therapy (CRT) implantation is greater between different poles within a vein, or greater between two different veins.

METHODS AND RESULTS:

The cardiac index (CI, L/min/m(2) ) was measured during CRT implantation using a noninvasive cardiac output monitor (NICOM™, Cheetah Medical Inc., Newton Center, MA, USA) and a quadripolar left ventricle (LV) lead, in 22 patients with sinus rhythm. CI was recorded during right atrial-biventricular pacing at 70/min with fixed atrioventricular and ventriculo-ventricular delay, from each LV electrode in one vein, and then from an alternate vein. Phrenic nerve stimulation (PNS) occurred in nine of 15 posterior and three of 21 anterior veins (P = 0.005). At least one electrode in each vein had no PNS. The mean (standard deviation [SD]) difference between best and worst CI within any one vein was 13.1% (±9%). The mean (SD) difference between the best CI in one vein compared to the other was 9.8% (±8%; P = 0.043). In 16 of 22 patients, the range of CI was greater between poles within one vein, rather than between two veins (best of one vein compared to best from the other). In four of 22 patients, the range was greater between veins (P = 0.0003).

CONCLUSION:

A greater range of CI is found within a single vein than between two different veins. This finding has implications both for the approach to implant technique and postimplant programming and optimization.

Videos

MEMBERSHIP CATEGORIES AND GUIDELINES

  • Members - Full time life members with voting rights: All those with DM/DNB cardiology qualification or equivalent and interest in arrhythmia/EP : Fees Rs 10,000.
  • Associate Members - DM/DNB/Fellows during training period. Fees Rs 3,000. No voting rights.
  • International Members: Overseas doctors with appropriate qualification and interest in arrhythmias. No voting rights. Fees 300$.
  • Industry members: Industry personnel associated with arrhythmology can become members. Membership is non-transferable. No voting rights. Fees 25,0000.
  • Any Associate Members who become eligible for Full time life membership (on completion of training period), need to pay only the balance of Rs 7,000 (10,000 - 3,000) if this is one within 1 year after completion of training. If the application for Full time life membership is received after expiry of one year of their entry as Associate Members, the full fees (viz Rs 10,000) shall apply.
  • Membership application need to be endorsed by two IHRS Members.
  • The application forms received by the office of Vice President, IHRS would need to be finally approved by the credentialing Committee (comprising of President, Secretary and Joint Secretary, IHRS).

Please print this form and send appropriate DD/Cheque in favour of Indian Heart Rhythm Society, and send through post to the following Address:

Dr Anil Saxena
Director, Cardiac Pacing & Electrophysiology
Fortis Escorts Heart Institute
Okhla Road, New Delhi, 110025 INDIA
Vice President, Indian Heart Rhythm Society
Mobile: +91 9810025511
Email: anil.saxena@hotmail.com
Secretary: +91 9910665566 (Ms Kumkum Sharma)