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Heart 2009;95:2030-2039 doi:10.1136/hrt.2009.171835
  • Technology and guidelines

Selective site right ventricular pacing

  1. K Albouaini1,
  2. A Alkarmi1,
  3. T Mudawi1,
  4. M D Gammage2,
  5. D J Wright1
  1. 1
    Liverpool Heart and Chest Hospital, Liverpool, UK
  2. 2
    Centre for Cardiovascular Science, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
  1. Correspondence to Dr K Albouaini, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK; Albouaini{at}aol.com
  • Accepted 25 August 2009
  • Published Online First 8 September 2009

Abstract

The right ventricular apex (RVA) has been the elective site for placing endocardial pacing leads since 1959 when Furman described the use of the transvenous route for pacemaker implantation. This site was used because it is easily accessible, readily identified and associated with a stable position and reliable chronic pacing parameters. It was recognised, however, that pacing from the RVA did not reproduce normal ventricular conduction or contraction. With the advent of reliable active fixation leads, alternative right ventricular sites became accessible and began to be explored. In this review, the detrimental effects of RVA pacing are outlined, the right ventricular outflow tract is defined and the evidence for selective site pacing is discussed.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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