Left Ventricular Lead Placement with Over-the-Wire Technique for Right Ventricular Pacing in a Patient with Distorted Vessels

作者：Yaminisharif Ahmad^*; Alemzadeh Ansari Mohammad Javad; Shafiee Akbar

来源：Texas Heart Institute Journal, 2013, 40(3): 281-282.

• Catheterization central venous/methods
• electrodes,implanted
• pacemaker,artificial
• punctures
• treatment outcome

Vascular access can present a clinical challenge in the implantation of permanent pacemaker leads. We describe the case of an 81-year-old man with complete heart block in whom it was difficult to find a suitable vein for advancing a pacemaker lead. The left cephalic vein was selected for lead implantation; however, because of a 90 degrees angle between the cephalic and axillary veins, the lead failed to advance. Because the patient was elderly and at high risk, we decided to place a left ventricular pacing lead in the right ventricle by means of an over-the-wire technique. After 1 month, the patient%26apos;s pacing threshold was good, and the lead remained in the right ventricular apex. When patients have distorted vessels and lead placement seems difficult or impossible, we think that the over-the-wire placement technique can be effective.

• 出版日期2013-6