Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1978 Jun;40(6):589–595. doi: 10.1136/hrt.40.6.589

Clinical experience with transvenous atrial pacing.

J S Geddes, S W Webb, I P Clements
PMCID: PMC483453  PMID: 656232

Abstract

Twelve patients were paced with a transvenous J-shaped bipolar electrode positioned in the right atrial appendage. All had chronic sinoatrial dysfunction and 5 had paroxysmal atrial arrhythmia: 2 had recent myocardial infarction, 1 angina decubitus, and 1 ventricular pre-excitation. Atrioventricular sequential pacing was employed in this last patient and this mode of pacing was substituted for atrial pacing in one other. The remaining 10 patients were paced from the atrium only. Electrode displacement occurred in 2 patients and 2 others had a rise in pacing threshold. After repositioning the electrode or substituting a more powerful pacemaker, sustained atrial capture was achieved in 3 of these 4. Sensing of spontaneous P waves was present constantly in 4 and variably in 3 of 9 patients. Symptomatic improvement was obtained in 10 patients. A bipolar pacemaker with a variable output voltage and a relatively high demand sensitivity is optimal for atrial pacing. Measurements of intra-atrial voltage with various electrode configurations in 7 patients suggest that atrial sensing may more often be achieved when the reference electrode is situated in the upper part of the right atrium than when it is close to the electrode tip in the atrial appendage.

Full text

PDF
589

Images in this article

591Image
on p.591
592Image
on p.592
594Image
on p.594

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aroesty J. M., Cohen S. I., Morkin E. Bradycardia-tachycardia syndrome: results in twenty-eight patients treated by combined pharmacologic therapy and pacemaker implantation. Chest. 1974 Sep;66(3):257–263. doi: 10.1378/chest.66.3.257. [DOI] [PubMed] [Google Scholar]
  2. Dreifus L. S., Berkovits B. V., Kimibiris D., Moghadam K., Haupt G., Walinsky P., Thomas P., Brockman S. K. Use of atrial and bifocal cardiac pacemakers for treating resistant dysrhythmias. Eur J Cardiol. 1975 Dec;3(4):257–266. [PubMed] [Google Scholar]
  3. Fields J., Berkovits B. V., Matloff J. M. Surgical experience with temporary and permanent A-V sequential demand pacing. J Thorac Cardiovasc Surg. 1973 Dec;66(6):865–877. [PubMed] [Google Scholar]
  4. Furman S., Reicher-Reiss H., Escher D. J. Atrioventricular sequential pacing and pacemakers. Chest. 1973 May;63(5):783–789. doi: 10.1378/chest.63.5.783. [DOI] [PubMed] [Google Scholar]
  5. Furman S. Therapeutic uses of atrial pacing. Am Heart J. 1973 Dec;86(6):835–840. doi: 10.1016/0002-8703(73)90289-5. [DOI] [PubMed] [Google Scholar]
  6. Kahn A., Morris J. J., Citron P. Patient-initiated rapid atrial pacing to manage supraventricular tachycardia. Am J Cardiol. 1976 Aug;38(2):200–204. doi: 10.1016/0002-9149(76)90150-8. [DOI] [PubMed] [Google Scholar]
  7. Moore C. B., Bower P. J. The sick sinus syndrome: treatment by permanent transvenous atrial pacing (a new approach). South Med J. 1975 May;68(5):580–583. [PubMed] [Google Scholar]
  8. Moss A. J., Rivers R. J., Jr, Kramer D. H. Permanent pervenous atrial pacing from the coronary vein. Long-term follow-up. Circulation. 1974 Feb;49(2):222–225. doi: 10.1161/01.cir.49.2.222. [DOI] [PubMed] [Google Scholar]
  9. Rubenstein J. J., Schulman C. L., Yurchak P. M., DeSanctis R. W. Clinical spectrum of the sick sinus syndrome. Circulation. 1972 Jul;46(1):5–13. doi: 10.1161/01.cir.46.1.5. [DOI] [PubMed] [Google Scholar]
  10. Smyth N. P., Citron P., Keshishian J. M., Garcia J. M., Kelly L. C. Permanent pervenous atrial sensing and pacing with a new J-shaped lead. J Thorac Cardiovasc Surg. 1976 Oct;72(4):565–570. [PubMed] [Google Scholar]
  11. Smyth N. P., Keshishian J. M., Bacos J. M., Massumi R. A., Fletcher R. D., Boivin M. R. Permanent pervenous atrial pacing. J Electrocardiol. 1971;4(4):299–306. doi: 10.1016/s0022-0736(71)80014-6. [DOI] [PubMed] [Google Scholar]
  12. Sutton R., Norman J., Briers L. Letter: Sick sinus syndrome. Br Med J. 1975 Aug 9;3(5979):367–368. doi: 10.1136/bmj.3.5979.367-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Udall J. A. Permanent pervenous transseptal atrial pacing. Canine experiments and a clinical case. Am J Cardiol. 1974 Jun;33(7):887–891. doi: 10.1016/0002-9149(74)90636-5. [DOI] [PubMed] [Google Scholar]
  14. Williams D. O., Davison P. H. Long-term treatment of refractory sypraventricular tachycardia by patient-controlled inductive atrial pacing. Br Heart J. 1974 Apr;36(4):336–340. doi: 10.1136/hrt.36.4.336. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Zucker I. R., Parsonnet V., Gilbert L. A method of permanent transvenous implantation of an atrial electrode. Am Heart J. 1973 Feb;85(2):195–198. doi: 10.1016/0002-8703(73)90460-2. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES