Radiographic appearances of implanted transvenous endocardial pacing electrodes

It is important to ensure correct positioning of long-term pacing electrodes. Electrocardiograms and the radiographic appearance of pacing electrodes are conventionally used to confirm the site of the pacing electrode. Electrocardiographic patterns from stimulation of the right ventricle and left ventricle of the heart through the coronary venous system and the limitations in the interpretations of these patterns have been well documented in the past. The appearances of chest x-ray films can also be misleading. In the present study performed on cadavers, detailed appearances of pacing electrodes placed electively in different sites in the right ventricle and in the coronary sinus and its radicles are described, and the limitations in the interpretations of such appearances are discussed.