Why the study?
Does the use of a retained guidewire improve the left ventricular pacing threshold in patients undergoing LV lead placement?
Does the use of a retained guidewire improve the left ventricular pacing threshold in patients undergoing LV lead placement?
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Retaining a guidewire in the pacing lead may be a useful technique to dramatically reduce LV pacing thresholds and avoid surgical epicardial lead placement in difficult cases.
Although transvenous access to the coronary veins has considerably simplified left ventricular (LV) pacing, it can remain a time consuming and arduous task achieving satisfactory pacing positions for the LV electrode. Common problems include negotiating small veins with adequate guide catheter stability, pacing electrode stability once positioned, and phrenic nerve stimulation. We report a case where use of the pacing lead guidewire resulted in a dramatic reduction in the pacing threshold of the LV lead, and saved the patient the need to undergo thoracotomy placement.
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Sankaranarayanan et al. (2007) studied this question.
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