Atrial pacing from the coronary vein. Ten-year experience in 50 patients with implanted pervenous pacemakers.

Moss, A. J.; Rivers, Robert J.

doi:10.1161/01.cir.57.1.103

Cited by 50 publications

(7 citation statements)

References 20 publications

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“…The CS lead and a right atrial (HA) lead screwed in the high RA free wall (2) were connected to a Y bifurcated adapter to permit biatrial synchronous pacing in a patient with major interatrial conduction block and drug refractory^ atrial arrhvthmias. A conventional right ventricular (RVj lead was placed at the RV apex (3) and connected to the ventricular port of the DDD pacemaker. decrease (23% on average) in A wave amplitude was observed, with a mean threshold level of 2.7 ± 1.6 mV (range 0.5-7mV) at the end of follow-up (NS).…”

Section: Chronic Pacing and Sensing Thresholdsmentioning

confidence: 99%

Permanent Left Atrial Pacing with a Specifically Designed Coronary Sinus Lead

Daubert

Leclercq

Breton

et al. 1997

Pacing Clinical Electrophis

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This article reports the original use of a specifically designed coronary sinus (CS) lead for permanent left atrial (LA) pacing. The device is characterized by its distal end shape featuring a double 45 degree angulation, which ensures very close contact with the CS upper wall. The device was successfully implanted in 39 out of 40 patients (97.5%). The tip electrode was eventually positioned in the distal CS in 9 patients, in the middle CS in 21 patients, and close to the ostium in the proximal CS in 9 patients. The mean acute pacing threshold voltage was 0.9 +/- 0.5 V with a mean impedance of 578 +/- 144 omega as measured in unipolar distal configuration at 0.5 ms pulse width (PW). The mean A wave amplitude was 3.5 +/- 2.1 mV. Early lead dislodgment occurred only once (3%) when the tip electrode was placed in the distal or middle CS, but more often (4/9 cases) when it was placed in the proximal CS. After a mean follow-up duration of 14 +/- 8.5 months, 35 of the 39 successfully implanted leads (89.7%) were still functional in terms of LA pacing and sensing. The mean chronic pacing threshold voltage was 1.5 +/- 0.8 V and the mean A wave amplitude was 2.7 +/- 1.6 mV. There were no lead related complications. In conclusion, the device proved to be safe and highly effective for permanent LA pacing, provided the distal tip could be positioned in the distal or middle part of the CS.

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Section: Chronic Pacing and Sensing Thresholdsmentioning

confidence: 99%

Permanent Left Atrial Pacing with a Specifically Designed Coronary Sinus Lead

Daubert

Leclercq

Breton

et al. 1997

Pacing Clinical Electrophis

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“…The first results of pacing in the coronary sinus (CS), were published by Moss and Rivers in 1978 [ 26 ]. He reported on a 10-year experience of CS pacing in a total number of 50 patients.…”

Section: Discussionmentioning

confidence: 99%

Right versus left atrial pacing in patients with sick sinus syndrome and paroxysmal atrial fibrillation (Riverleft study): study protocol for randomized controlled trial

Ramdjan

Does

Knops

et al. 2014

Trials

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BackgroundThe incidence of sick sinus syndrome will increase due to population ageing. Consequently, this will result in an increase in the number of pacemaker implantations. The atrial lead is usually implanted in the right atrial appendage, but this position may be ineffective for prevention of atrial fibrillation. It has been suggested that pacing distally in the coronary sinus might be more successful in preventing atrial fibrillation episodes. The aim of this trial is to study the efficacy of distal coronary sinus versus right atrial appendage pacing in preventing atrial fibrillation episodes in patients with sick sinus syndrome.Methods/DesignThis study is designed as a multicenter, randomized controlled trial. Patients with sick sinus syndrome and at least one atrial fibrillation episode of 30 seconds or more in the six months before recruitment will be eligible for participation in this study.All participants will be randomized between pacing distally in the coronary sinus and right atrial appendage. Randomization is stratified for all participating centers. Conventional dual-chamber pacemakers with advanced home monitoring functionality will be implanted. The ventricular lead will be implanted in the right ventricular apex. The first three months of the 36-month follow-up period are considered as run-in time. During the pre-randomization visit and follow-up, an interview, electrocardiogram and pacemaker assessment will be performed, prescribed antiarrhythmic medication will be reviewed and patients will be asked to complete an SF-36 questionnaire. An echocardiographic examination will be conducted in the pre-randomization phase and at the end of each follow-up year. Home monitoring will be used to send daily reports in case of atrial fibrillation episodes.DiscussionThis randomized controlled trial is the first in which home monitoring will be used to compare atrial fibrillation recurrences between pacing in the distal coronary sinus or right atrial appendage. Home monitoring gives the opportunity to accurately detect atrial fibrillation episodes and to study characteristics of atrial fibrillation episodes. Should distal coronary sinus pacing significantly diminish atrial fibrillation recurrences, this study will redefine the preferential location of an atrial lead for preventive pacing.Trial registrationCurrent Controlled Trials ISRCTN65911661, registered on 8 July 2013.

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“…Once venous access has been achieved percutaneously with the guidewire inserted transhepatically, a sheath set is applied, affording the subsequent introduction of a permanent pacemaker electrode. 164,165 The problems with CS atrial pacing have been access and lead stability. 16:1753, 1993.…”

Section: E4 Section 4 Implantation Techniquesmentioning

confidence: 99%