Pacemaker Implant Anatomy - Step-by-Step (Part 3)

Pacemaker Implant Anatomy – Step-by-Step (Part 3)

Ventricular Lead

One of many ways to enter the ventricle is to make bend of about 90 degree bend in the stylet. Position the sharply curved lead in the direction of the tricuspid ostium. Advancement of the lead in this position will usually cross the tricuspid valve.

Some extra support from the stylet, by advancing lead and stylet at the same time, can be helpful. In many cases this simple manipulation is enough to attain a proper apical ventricular position. (Refer to Figures 19 and 20)

Figure 19 (Part 1)

Figure 19 (Part 1)

Figure 19 (Part 2)

Figure 19 (Part 2)

Figure 19 (Part 3)

Figure 19 (Part 3)

Figure 19 (Part 4)

Figure 19 (Part 4)

Figure 20: When a ventricular lead is introduced the lead will show a nice curve over the tricusped valve ring. On fluoroscopy the lead will follow valve movement.

Figure 20: When a ventricular lead is introduced the lead will show a nice curve over the tricusped valve ring. On fluoroscopy the lead will follow valve movement.

 

Continue to Part 4

 

Author:

Stuart Allen
Principal Cardiac Physiologist
Manchester Heart Centre
Manchester, UK

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