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Chest, Vol 101, 1194-1196, Copyright © 1992 by American College of Chest Physicians

ARTICLES

Optimal lead positioning for postoperative atrial pacing

GH Almassi, JN Wetherbee, RG Hoffmann and GN Olinger
Department of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee.

Temporary atrial pacing leads have uncontested utility for diagnosis and treatment of postoperative supraventricular arrhythmias. Sensing and capture thresholds may be inconsistent, however. We evaluated intraoperative atrial sensing amplitude and capture thresholds in 25 patients after coronary bypass using six bipolar and four unipolar lead combinations based on four lead positions: A, atrial appendage; B, 1 cm above the presumed sinoatrial node at the atrial-superior-vena caval junction; C, interatrial groove at the right superior pulmonary vein; and D, caudal inferolateral free wall. Unipolar lead B and bipolar lead B-D had the best voltage pacing threshold and system resistance (p less than 0.05). The lowest current was also observed with unipolar lead B and bipolar lead B-D, but the difference was not significant (p greater than 0.05). P-wave amplitude was not significantly different for any lead combination. Location C, in unipolar or bipolar combinations, frequently paced the phrenic nerve. These data provide new guidelines for establishment of postoperative temporary atrial pacing leads.


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 Ann. Thorac. Surg.Home page
I. Kashima, R. Aeba, T. Katogi, and S. Kawada
Optimal position of atrial epicardial leads for temporary pacing in infants after cardiac surgery
Ann. Thorac. Surg., June 1, 2001; 71(6): 1945 - 1948.
[Abstract] [Full Text] [PDF]


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Copyright © 1992 by the American College of Chest Physicians.