Can QRS morphology be used to differentiate between true septal vs. apparently septal lead placement? An analysis of ECG of real mid-septal, apparent mid-septal, and apical pacing

European Heart Journal Supplements : Journal of the European Society of Cardiology
Anna MalaRobert Petr

Abstract

The location of the pacemaker lead is based on the shape of the lead on fluoroscopy only, typically in the left and right anterior oblique positions. However, these fluoroscopy criteria are insufficient and many leads apparently considered to be in septum are in fact anchored in anterior wall. Periprocedural ECG could determine the correct lead location. The aim of the current analysis is to characterize ECG criteria associated with a correct position of the right ventricular (RV) lead in the mid-septum. Patients with indications for a pacemaker had the RV lead implanted in the apex (Group A) or mid-septum using the standard fluoroscopic criteria. The exact position of the RV lead was verified using computed tomography. Based on the findings, the mid-septal group was divided into two subgroups: (i) true septum, i.e. lead was found in the mid-septum, and (ii) false septum, i.e. lead was in the adjacent areas (anterior wall, anteroseptal groove). Paced ECGs were acquired from all patients and multiple criteria were analysed. Paced ECGs from 106 patients were analysed (27 in A, 36 in true septum, and 43 in false septum group). Group A had a significantly wider QRS, more left-deviated axis and later transition zone compared with th...Continue Reading

Associated Clinical Trials

References

Mar 15, 1997·Journal of the American College of Cardiology·H F Tse, C P Lau
Jun 11, 2004·Pacing and Clinical Electrophysiology : PACE·Randy LiebermanMichael D Gammage
Apr 29, 2006·Journal of Cardiovascular Electrophysiology·Frederic VictorJ Claude Daubert
Oct 14, 2006·Pacing and Clinical Electrophysiology : PACE·Andrew D McGaviganHarry G Mond
Apr 18, 2007·Pacing and Clinical Electrophysiology : PACE·Harry G MondAndrew D McGavigan
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May 11, 2010·The American Journal of Cardiology·Oscar CanoJosé Olagüe
Sep 11, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Haran BurriDipen Shah
Jul 30, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Avi ShimonyGuy Amit
Dec 28, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Haran BurriCarine Stettler
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Jul 9, 2016·International Journal of Cardiology·Akira MizukamiYuji Hashimoto
Mar 1, 2017·Pacing and Clinical Electrophysiology : PACE·Matthew K RoweGerald C Kaye

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