Preliminary Experience with the Helifix Electrode for Transvenous Atrial Implantation

Abstract

A Helifix electrode was inserted transvenously in the right atrial appendage for temporary atrial stimulation in three patients. The low stimulation threshold as well as the excellent stability of the electrode encouraged us to proceed to permanent implantation of this lead in thirteen patients. The lead was introduced through the saphenous vein in twelve patients and through the cephalic vein in one patient. Five patients had sinoatrial dysfunction and five had bradycardia-tachycardia syndrome; they received atrial demand pacemakers. Two patients had atrioventricular block and received atrial synchronous ventricular pacemarkers. Our last patient had restrictive cardiomyopathy, heart failure and a drug-refractory atrial arrhythmia. She received a dual-chamber sequential pacing device. Atrial electrode displacement occurred in one patient soon after implantation. The lead was promptly repositioned without difficulty. Partial sensing of spontaneous P waves was observed in two patients. One recovered spontaneously, the second after substituting a pulse generator with a higher input sensitivity. Our clinical experience during the period from November 1977 to January 1979 has shown that the Helifix electrode is suitable for transvenous atrial implantation.

Permanent Transfemoral Pacemaker: A Single‐Center Series Performed with an Easier and Safer Surgical Technique

“…In the early days of this approach, a surgical incision extending down to the femoral‐iliac vein was utilized 7,9,14 . This surgical technique was first described by El Gamal and Van Gelder 4 and was followed almost unchanged by most “iliac entry site implanters” afterwards 6,7,9,15 . Although venous access has been described as “femoral” in some reports, 5 the iliac vein was the main venous entry site.…”

“…The benefit of ilio‐femoral venous access is that it continues to utilize endocardial leads with their superb capture and sensing thresholds while decreasing implant complications and overall and procedure costs. Venous access utilizing the ilio‐femoral system was first reported in 1979, 4 but there are few published studies and only a few hospitals perform this procedure worldwide.…”

Occluded superior vena cava and failed epicardial pacing: An unorthodox solution

“…Ilio-femoral access for permanent pacing was irst described by El Gamal and Van Gelder almost 40 years ago [6]. Femoral vein [7], iliac vein [1,8] and direct inferior vena cava [9], approaches have since been used for lead placement in cases of SVC occlusion.…”

Femoral approach: An exceptional alternative for permanent pacemaker implantation

“…Ellestad et al and Mathur et al reported a dislodgment rate of 21% and 20%, respectively, even with the use of activefixation leads. 6,7 Gravity plays an important role, exerting a force on the whole length of the lead, which is suspended from its anchor point in the myocardium, in contrast to leads inserted from the pectoral area. Correct positioning of the lead is therefore of the utmost importance.…”