lv leads Methods: The LV lead location was classified in 797 patients with CRT-D, in 569 patients with left bundle branch block (LBBB), in 228 patients with non-LBBB, and in 505 patients with an implantable cardioverter-defibrillator (ICD) only. Leads were classified into apical (n = 83) and non-apical (n = 486); with the non-apical LV leads further . Song
0 · where are epicardial leads placed
1 · what is an epicardial lead
2 · ventricular epicardial lead
3 · surgical epicardial lead placement
4 · lv lead revision
5 · lv lead placement
6 · coronary sinus pacer lead
7 · coronary sinus lead
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where are epicardial leads placed
Improved outcome to CRT has been associated with the placement of a left ventricular (LV) lead in the latest activated segment free from scar. The majority of randomized controlled trials investigating guided LV lead . Cardiac resynchronization therapy (CRT) is a modality of cardiac pacing that provides simultaneous or nearly simultaneous electrical activation of the LV and right ventricle . CRT is a mainstay in the management of heart failure patients with electrical dyssynchrony. LV lead positioning remains an important variable that predicts response to .Left Ventricular Leads. Optimal left ventricular (LV) pacing requires placement of the lead in a stable location that is free of significant phrenic nerve stimulation (PNS) and is likely to result in .
Methods: The LV lead location was classified in 797 patients with CRT-D, in 569 patients with left bundle branch block (LBBB), in 228 patients with non-LBBB, and in 505 patients with an implantable cardioverter-defibrillator (ICD) only. Leads were classified into apical (n = 83) and non-apical (n = 486); with the non-apical LV leads further . However, LV epicardial lead placement is associated with increased rates of complications such as renal insufficiency and infections. 5 With the advancements made in tools and techniques for LV lead delivery, the implanting electrophysiologist now has a variety of approaches to adopt when encountering challenging LV lead implants to obtain the . Surgical LV lead placement offers the advantage of direct access to the lateral left ventricular wall. Direct visualisation provides an almost unrestricted opportunity to implant the leads at the optimal target site, so that the pre-determined lead position was achieved in .
To facilitate stable left ventricular (LV) lead placement, it is practical first to place the right ventricular (RV) pacing lead and then to advance the LV lead into the coronary sinus (CS) branch, leaving the sheath in place. After the right atrial (RA) lead is positioned, the LV lead guiding sheath is removed, and the LV lead is sutured in place. The LV lead position was assessed in 799 patients by means of coronary venograms and chest x-rays recorded at the time of device implantation. The LV lead location was classified along the short axis into an anterior, lateral, or posterior position and along the long axis into a basal, midventricular, or apical region. Purpose of Review Cardiac resynchronization therapy (CRT) represents a well-established and effective non-pharmaceutical heart failure (HF) treatment in selected patients. Still, a significant number of patients remain CRT non-responders. An optimal placement of the left ventricular (LV) lead appears crucial for the intended hemodynamic and hence clinical . Cardiac resynchronization therapy (CRT) is a modality of cardiac pacing that provides simultaneous or nearly simultaneous electrical activation of the LV and right ventricle (RV) via stimulation of the LV and RV (biventricular pacing) or LV alone. CRT devices pace the LV via a lead placed in a branch of the coronary sinus or, less commonly, via .
LV lead pulse width (t, seconds) was the same for both groups. Whilst the capture threshold (V) was significantly lower with the active fixation lead, the impedance (I) was similarly lower, therefore there were no significant differences in the threshold energy between the two groups. Documentation of the final LV lead position obtained using .ACUITY™ X4 Quadripolar LV Leads. New Solutions. Meaningful Outcomes. ACUITY™ X4 Quadripolar LV leads are the first and only LV leads uniquely designed to promote non-apical pacing options, helping physicians to pace from an optimal site for improved CRT response.CRT Leads Overview. Our broad choices of leads to navigate diverse anatomies enhance the chance of success during the implant procedure. Designs are available for stability in different vein sizes and programming options to avoid phrenic nerve stimulation. Attain Stability Quad; Attain Performa; Attain Ability
The LV lead location was classified in 797 patients with CRT-D: 569 patients with left bundle branch block (LBBB) and 228 with non-LBBB. Leads were classified into apical (n = 83) and nonapical (n = 486), with the nonapical LV leads further categorized into anterior (n = 99) and posterior/lateral (n = 387) within LBBB. . ABSTRACT. Expanding indications for cardiac resynchronization therapy (CRT) and emerging data on the importance of targeted left ventricular (LV) lead placement have resulted in renewed focus on refining implantation technique. Many implanting physicians use an “over-the-wire” approach to LV lead placement that may not provide enough support for lead .
ACUITY™ X4 Quadripolar LV Leads - Indications, Safety and Warnings. The Boston Scientific ACUITY X4 lead is a steroid-eluting (dexamethasone acetate) IS4 quadripolar lead.
Markedly increased LV voltages: huge precordial R and S waves that overlap with the adjacent leads (SV2 + RV6 >> 35 mm). R-wave peak time > 50 ms in V5-6 with associated QRS broadening. LV strain pattern with ST depression and T-wave inversions in I, aVL and V5-6.
Inadvertent placement of a ventricular lead into the left ventricle (LV) is a rare complication during cardiovascular implantable electronic device (CIED) implantation. In a retrospective study of 2579 patients undergoing CIED implantation, 6 patients (0.34%) had inadvertent lead malposition in the left heart—4 in the LV and 1 each in left atrium and .
In-patient heart failure hospitalization rates and LV lead surgical revisions were 54% lower for the quadripolar group (0.15/patient-year than for the bipolar LV group (0.32/patient-year) (p = 0.04). 5; The hospitalization rate reduction was accompanied with statistically significant cost savings of 62% (p = 0.016). 5The stimulation polarity is programmable in the left ventricle by choosing a quadripolar (4 electrodes) or non-quadripolar (1 or 2 electrodes) lead. If a unipolar LV lead is implanted, a single configuration (LV tip à RV ring or RV coil) might .INSERTION OF LEAD(S) 33216 Insertion of single lead 5.62 7 NA 33217 Insertion of two leads 5.59 0 NA 33224 Insertion of pacing LV lead, with attachment to previously placed pacemaker or ICD generator including revision of pocket, removal, insertion and/or replacement of existing generator 9.04 9 NA +33225Quartet™ LEFTfiHEART LEADS Family of LV Leads Physical Specifications MODELS 1458Q 1456Q 1457Q 1458QL Parameter Description Description Description Description Connector IS4-LLLL IS4-LLLL IS4-LLLL IS4-LLLL Lead Length 75; 86; 92 cm 75; 86 75; 86 cm 75; 86 Maximum Lead Size 5.1 F (1.70 mm/0.067”) at the ring electrode
Quartet Family of LV Leads Specifications This document features product highlights, ordering information and physical specifications for the Quartet™ LV lead family. *Indicates lead lengths that are MR Conditional (field strength of 1.5T or 3T, depending on MRI Ready device).
what is an epicardial lead
Optimal LV lead positioning within the coronary sinus tributaries is an important determinant of CRT response. Randomized trials have demonstrated superior CRT response and lower mortality and hospitalizations for heart failure when an echo-guided approach is used to target the LV lead to the site of the latest mechanical activation [6, 7].The ECG leads. Before discussing the ECG leads and various lead systems, we need to clarify the difference between ECG leads and ECG electrodes.An electrode is a conductive pad that is attached to the skin and enables the recording of electrical currents. An ECG lead is a graphical description of the electrical activity of the heart and it is created by analyzing several electrodes.
A variety of imaging and mapping methods have been used by several groups to investigate the effectiveness of targeted LV lead placement in CRT, as documented in Online Supplemental Table A and Figure 1.This article aims to provide a comprehensive overview of the different techniques used for LV lead placement and evaluate the scientific evidence .Objectives Assess safety and performance of novel quadripolar preshaped left ventricular (LV) leads: NAVIGO 4LV 2D (‘S shaped’) and NAVIGO 4LV ARC (‘U shaped’). Methods Patients indicated for cardiac resynchronisation therapy were enrolled in a multicentre, prospective, controlled study (NAVIGATOR, [NCT03279484][1]). Patients were implanted with either a .Important Safety Information Quartet™ LV Lead. Rx Only. Brief Summary: Prior to using these devices, please review the User’s Manual for a complete listing of indications, contraindications, warnings, precautions, potential adverse events and directions for use. Indications and Usage: The Quartet™ leads are 5.1 French, transvenous, steroid eluting, quadripolar, IS4 compatible .Quartet™ Quadripolar LV Lead. The Quartet quadripolar LV lead offers superb deliverability with exceptional stability and performance. With four electrodes and up to 14 pacing configurations, the quadripolar system enables left ventricular (LV) pacing .
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