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  1. Article: Optimal lead positioning for postoperative atrial pacing.

    Almassi, G H / Wetherbee, J N / Hoffmann, R G / Olinger, G N

    Chest

    1992  Volume 101, Issue 5, Page(s) 1194–1196

    Abstract: Temporary atrial pacing leads have uncontested utility for diagnosis and treatment of postoperative ... for establishment of postoperative temporary atrial pacing leads. ... bipolar and four unipolar lead combinations based on four lead positions: A, atrial appendage; B, 1 cm ...

    Abstract Temporary atrial pacing leads have uncontested utility for diagnosis and treatment of postoperative supraventricular arrhythmias. Sensing and capture thresholds may be inconsistent, however. We evaluated intraoperative atrial sensing amplitude and capture thresholds in 25 patients after coronary bypass using six bipolar and four unipolar lead combinations based on four lead positions: A, atrial appendage; B, 1 cm above the presumed sinoatrial node at the atrial-superior-vena caval junction; C, interatrial groove at the right superior pulmonary vein; and D, caudal inferolateral free wall. Unipolar lead B and bipolar lead B-D had the best voltage pacing threshold and system resistance (p less than 0.05). The lowest current was also observed with unipolar lead B and bipolar lead B-D, but the difference was not significant (p greater than 0.05). P-wave amplitude was not significantly different for any lead combination. Location C, in unipolar or bipolar combinations, frequently paced the phrenic nerve. These data provide new guidelines for establishment of postoperative temporary atrial pacing leads.
    MeSH term(s) Arrhythmias, Cardiac/diagnosis ; Arrhythmias, Cardiac/etiology ; Arrhythmias, Cardiac/therapy ; Cardiac Pacing, Artificial/methods ; Coronary Artery Bypass ; Electrodes ; Humans ; Intraoperative Period ; Postoperative Complications
    Language English
    Publishing date 1992-05
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1378/chest.101.5.1194
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Optimal positioning of temporary epicardial atrial pacing leads after cardiac surgery.

    Kashima, I / Shin, H / Yozu, R / Kawada, S

    The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai zasshi

    2001  Volume 49, Issue 5, Page(s) 307–310

    Abstract: ... after cardiac surgery. We studied the optimal positioning for temporary epicardiac atrial pacing ... Methods: The performance of temporary epicardiac atrial pacing leads was examined after 13 cases ... lead as the ground. The pacing threshold was measured at a 0.5 ms pulse width, using the P wave ...

    Abstract Objectives: Atrial pacing plays an important role in preventing low output syndrome and arrhythmia after cardiac surgery. We studied the optimal positioning for temporary epicardiac atrial pacing.
    Methods: The performance of temporary epicardiac atrial pacing leads was examined after 13 cases of elective coronary artery bypass grafting between October 1999 and January 2000. Two bipolar electrode leads were used--1 on the cephalic atrial wall between the left and right atrial appendages, where the Bachmann bundle indwells (site A), and the other on the interatrial groove (site B). To assess pacing performance on postoperative days 1, 2, and 7, we measured 3 pacing patterns--bipolar use of sites A and B leads, and combined use of the 2 with the site A lead acting as the negative electrode and the site B lead as the ground. The pacing threshold was measured at a 0.5 ms pulse width, using the P wave amplitude and slew rate as indicators of sensing performance.
    Results: Bipolar pacing both at sites A and A-B was superior to that at site B in pacing threshold and sensing parameters.
    Conclusions: The negative electrode at site A is mandatory for high atrial pacing and sensing performance.
    MeSH term(s) Cardiac Pacing, Artificial/methods ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Electrodes, Implanted ; Heart Atria ; Humans ; Pericardium ; Postoperative Care
    Language English
    Publishing date 2001-05
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 604108-5
    ISSN 1344-4964 ; 0369-4739
    ISSN 1344-4964 ; 0369-4739
    DOI 10.1007/bf02913138
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  3. Article: Optimal position of atrial epicardial leads for temporary pacing in infants after cardiac surgery.

    Kashima, I / Aeba, R / Katogi, T / Kawada, S

    The Annals of thoracic surgery

    2001  Volume 71, Issue 6, Page(s) 1945–1948

    Abstract: ... to identify the optimal position for temporary atrial pacing.: Methods: Unipolar electrodes were fixed ... in terms of the pacing threshold, P-wave amplitude, slew rate, and lead impedance.: Results: Unipolar ... pacing of the right atrial appendage showed a significantly higher threshold than the other groups ...

    Abstract Background: The atrial epicardial wall of pediatric patients was topographically assessed to identify the optimal position for temporary atrial pacing.
    Methods: Unipolar electrodes were fixed at the cephalic wall between the right and left atrial appendages, the interatrial groove, and the right atrial appendage of fifteen pediatric patients who underwent definitive surgical repair. The performance of the three electrodes in terms of pacing patterns and six combinations of bipolar pacing were evaluated in terms of the pacing threshold, P-wave amplitude, slew rate, and lead impedance.
    Results: Unipolar pacing of the right atrial appendage showed a significantly higher threshold than the other groups. A bipolar configuration of the cephalic atrial wall and interatrial groove had a significantly higher P-wave amplitude than groups without the electrode at the cephalic atrial wall, and a significantly higher slew rate than a unipolar configuration of the atrial appendage.
    Conclusions: Bipolar pacing with the negative electrode at the cephalic atrial wall and the indifferent electrode at the interatrial groove is the most efficient method for pediatric patients.
    MeSH term(s) Cardiac Pacing, Artificial ; Electrocardiography ; Electrodes ; Female ; Heart Atria/physiopathology ; Heart Defects, Congenital/surgery ; Humans ; Infant ; Male ; Postoperative Care ; Postoperative Complications/physiopathology ; Postoperative Complications/therapy ; Treatment Outcome
    Language English
    Publishing date 2001-06-08
    Publishing country Netherlands
    Document type Comparative Study ; Journal Article
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/s0003-4975(01)02635-2
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  4. Article ; Online: Contrast-enhanced computed tomography for optimizing the outcomes of pulmonary vein isolation with cryoablation -the role of isolation of PVs including carina.

    Sakamoto, Yusuke / Osanai, Hiroyuki / Tanaka, Yuki / Hiramatsu, Shotaro / Matsumoto, Hikari / Tagahara, Kensuke / Hosono, Hirotaka / Miyamoto, Shun / Kondo, Shun / Kanbara, Takahiro / Nakashima, Yoshihito / Asano, Hiroshi / Ajioka, Masayoshi

    Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing

    2021  Volume 64, Issue 2, Page(s) 455–461

    Abstract: ... reconnection was observed in 2 patients. None of the patients had postoperative atrial flutter.: Conclusions ... factors and the position of the pulmonary vein (PV). Further, inadequate isolation of the carina leads ... to recurrence of atrial fibrillation (AF). We aimed to determine whether using contrast-enhanced computed ...

    Abstract Purpose: Compared with conventional pulmonary vein isolation (PVI) with radiofrequency ablation, PVI with cryoballoon is an easier and shorter procedure without reconnection, particularly in the superior pulmonary vein. However, the durability of the cryoballoon may be reduced due to anatomical factors and the position of the pulmonary vein (PV). Further, inadequate isolation of the carina leads to recurrence of atrial fibrillation (AF). We aimed to determine whether using contrast-enhanced computed tomography (CT) for patient selection improves the early success rate and prevents the recurrence of AF in PVI with cryoballoon.
    Methods: We evaluated patients who underwent ablation for paroxysmal atrial fibrillation in our hospital between July 2019 and November 2020. After excluding patients with contraindications for cryoablation, 50 patients were selected through visual inspection of the results of preoperative contrast-enhanced CT. A treatment plan was established, and the clinical course and outcomes were followed up.
    Results: Of the 200 PVs of the 50 patients, only 8 PVs (4%) were incompletely isolated with a single cryoablation. Six of the eight PVs were successfully isolated with additional cryoablation. Only 2 patients (4%) underwent additional PVI with radiofrequency ablation. Four patients had AF recurrence within a mean follow-up period of 14.3 ± 5.1 months. The rate of sinus rhythm maintenance was 92%. PV reconnection was observed in 2 patients. None of the patients had postoperative atrial flutter.
    Conclusions: Selecting patients for cryoablation according to contrast-enhanced CT findings made the procedure easier to perform, leading to improved early success rates and clinical course.
    MeSH term(s) Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/surgery ; Catheter Ablation/methods ; Cryosurgery/methods ; Humans ; Pulmonary Veins/diagnostic imaging ; Pulmonary Veins/surgery ; Recurrence ; Tomography, X-Ray Computed ; Treatment Outcome
    Language English
    Publishing date 2021-08-25
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1329179-8
    ISSN 1572-8595 ; 1383-875X
    ISSN (online) 1572-8595
    ISSN 1383-875X
    DOI 10.1007/s10840-021-01052-5
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