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Biventricular pacing using two pacemakers and the triggered VVT mode.
B O'Cochlain1, D Delurgio, A Leon
1Emory University, Atlanta, Georgia, USA.
Pacing and Clinical Electrophysiology : PACE
|August 29, 2001
Summary
Pacemaker patients with blocked veins can still receive biventricular pacing. A new technique successfully upgraded a patient with a blocked vein to biventricular pacing.
Area of Science:
- Cardiology
- Biomedical Engineering
- Electrophysiology
Background:
- Pacemaker-dependent patients often develop interventricular conduction delay from right ventricular lead placement.
- Biventricular pacing using a coronary sinus lead can effectively manage this delay.
- Venous stenosis or thrombosis affects up to 35% of patients post-pacemaker implantation.
Observation:
- This case report details a patient with a pre-existing left-sided dual-chamber pacemaker and chronic left subclavian vein occlusion.
- The patient's system was upgraded to biventricular pacing.
Findings:
- A coronary sinus lead was successfully placed for biventricular pacing.
- A single-chamber ventricular-triggered pacemaker was implanted on the contralateral side.
- This approach circumvented the occluded left subclavian vein.
Implications:
- This demonstrates a viable strategy for upgrading pacemaker systems in patients with venous occlusive disease.
- It highlights the adaptability of biventricular pacing in complex venous anatomies.
- This approach may improve outcomes for pacemaker-dependent patients with prior lead complications.