RVOT起搏導丝塑形与定位.pptVIP

* * * Figure 2. Fluoroscopic appearances of an active-fixation lead positioned in the RVOT septum. The posteroanterior (PA) and 40? right anterior oblique (RAO) views confirm the lead is in the RVOT. The tip of the lead in the 40? left anterior oblique (LAO) is pointing to the right over the spinal column and in the left lateral view (LL) the ventricular leads faces away from the sternum. These two positions confirm posterior or septal placement. Figure 3 40 left anterior oblique fluoroscopic chest images to demonstrate lead positions in the right ventricle. Left: Right ventricular outflow tract septal with the lead tip pointing towards the vertebral column (black arrow). The atrial lead points anterior. Middle: Anterior mid-right ventricle with the red arrow pointing upwards. Right: Mid-right ventricle free wall with the lead tip pointing anterior away (red arrow) from the vertebral column. The atrial lead also points anterior. * Figure 5. Posteroanterior fluoroscopic images in an alphabetical sequence to demonstrate the most common way of passing the active-fixation lead to the pulmonary artery. Note the metal sutures from previous open-heart surgery. (A) The lead fully loaded with the septal stylet is advanced across the tricuspid valve and directed toward the RV apex. (B, C) With the stylet slightly withdrawn, the body of the lead is arched into the RVOT. (D) The lead tip is the prolapsed into the pulmonary artery. * The QRS width was slightly longer with RVOT septal pacing compared to mid-RV septal pacing without reaching statistical significance (P = 0.15). Figure 2. Left: Illustration of the right ventricle (RV) septum. The white heavy line is the boundary between the RV outflow tract (RVOT) above and the mid-RV below (black circles). This line represents a His-bundle catheter passed across the roof of the tricuspid valve. Right: Radiographic views; posterior-anterior (PA) and 40? left anterior oblique (LAO) of the leads on the RV septum. The superior lead