Permanent Pervenous Atrial Synchronized Ventricular Pacing

Permanent pervenous atrial synchronized ventricular pacing was successfully accomplished in three patients. Atrial sensing was obtained from an electrode positioned in the coronary vein. Atrial electrograms with P waves greater than 1.5 mv were present in all three cases. Ventricular stimulation was accomplished through a separate electrode placed in the right ventricular apex. The left cephalic vein admitted both catheters, and the two electrodes were connected to an implantable P wave synchronized unit. The beneficial hemodynamic effects of atrial synchronized ventricular pacing were clinically evident. This new pervenous technique provides an optimal method of synchronized pacing in patients with heart block, intact sinoatrial activity and significantly compromised cardiac function.