Permanent Pacemaker and Implantable Cardioverter-Defibrillator Implantation in Adults

2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA)

“…Epicardial leads are currently implanted using various (minimally invasive) thoracotomy or thoracoscopy and robotic techniques. 35 Cardiac dyssynchrony is a difference in the timing of electrical and mechanical activation of the ventricles, which can result in impaired cardiac efficiency. CRT delivers biventricular pacing to correct electromechanical dyssynchrony in order to increase cardiac output.…”

Lead management in setting of limited venous accesses: A case report and review of literature

“…Numerous tunneling techniques are described in the literature. 5 These include the use of commercial tunneling tools (eg, a central line kit that is shaped like a knitting needle). The simplest technique is to use a Kelly clamp to dissect the subcutaneous tissue from receiving to satellite wound.…”

Uncommon Iatrogenic Devices Seen on Chest Radiographs

“…Permanent epicardial pacing involves surgical placement of the epicardial leads directly on the epicardium. The leads are then tunneled through the chest wall and connected to the pacing box usually in the subcutaneous pocket of the upper abdomen 5 (►Fig. 12).…”

“…Currently, they are used only in unusual circumstances such as patients with recurrent dislodgement of transvenous systems, patients with prosthetic tricuspid valves or congenital anomalies such as tricuspid atresia, and in patients underlying CRT in whom the coronary sinus lead placement was unsuccessful. 5 Temporary epicardial pacing is commonly used following cardiothoracic surgery in which the pacemaker leads are attached to the epicardium of the atrium and/or ventricle and then connected to the external pacer. 6 These leads are generally used in temporary treatment of arrhythmias in the perioperative period, and usually removed by 4 to 5 days after cardiac surgery by transcutaneous retraction.…”