Electrical activation in the coronary sinus branches as a guide to cardiac resynchronisation therapy: rationale for a coordinate system.

Background: For successful cardiac resynchronisation therapy (CRT) a spatial and electrical separation of right and left ventricular electrodes is essential. The spatial distribution of electrical delays within the coronary sinus (CS) tributaries has not yet been identified.

Objective: Electrical delays within the CS are described during sinus rhythm (SR) and right ventricular pacing (RVP).

Gold-coated pacemaker implantation after allergic reactions to pacemaker compounds.

An 86-year-old man underwent pacemaker implantation for symptomatic atrio-ventricular block grade 2 Mobitz II. The patient suffered repeated admissions for iterative sterile wound necrosis, leading to two generator re-implantations. No bacterial infection was detected in the microbiological screening tests.

Epicardial and pleural lead ICD systems in children and adolescents maintain functionality over 5 years.

Aims: The optimal implantable cardioverter defibrillator (ICD) system implant technique has not yet been defined in young patients and those with congenital heart disease (CHD). We describe our 5-year experience with epicardial pacing/sensing leads secured on the left cardiac chambers and a pleural defibrillation lead insertion along the third intercostal space.

Methods And Results: Implantable cardioverter defibrillator systems were implanted in 15 children and adolescents (age: 2.

A 12-year experience of bipolar steroid-eluting epicardial pacing leads in children.

Background: Cardiovascular abnormalities and small vascular size may preclude transvenous pacing and necessitate epicardial lead implantation. This study evaluates the performance of steroid-eluting, bipolar epicardial pacing leads.

Methods: We prospectively enrolled 114 children with 239 atrial and ventricular bipolar epicardial leads (Medtronic CapSure 10366 or 4968, Minneapolis, MN), followed up to 12.

Initial experience with implantable cardioverter defibrillator systems using epicardial and pleural electrodes in pediatric patients.

Implantable cardioverter defibrillators in children have proven to be an effective therapy for life-threatening ventricular arrhythmias. The optimal electrode and device placement for implantable cardioverter defibrillator therapy in children is still controversial. We describe our initial experience after epicardial and pleural electrode insertion with abdominal or intrathoracic device placement in 8 children.

Long-term follow-up after pacemaker implantation in neonates and infants.

Background: Pacemaker (PM) system implantation in neonates and infants is often complicated by hemodynamic instability, small vessel size, and abnormal cardiovascular anatomy. Thus, an open surgical approach for epicardial lead insertion is often required. We assessed the long-term outcomes after epicardial PM implantation in this age group.

Dual chamber epicardial pacing for the failing atriopulmonary Fontan patient.

Background: The atriopulmonary Fontan circulation leads to arrhythmias, heart failure, or protein-losing enteropathy, eventually requiring conversion. In hesitant patients, we evaluated the effect of dual chamber pacing as a time-buying measure.

Methods: Between 1997 and 2004, 9 patients (aged, 6 to 18 years) with an atriopulmonary Fontan connection and sinus node dysfunction received dual chamber epicardial pacemaker systems.

Left heart atrial and ventricular epicardial pacing through a left lateral thoracotomy in children: a safe approach with excellent functional and cosmetic results.

Objective: Left heart atrial and ventricular epicardial pacing through a left lateral thoracotomy is an alternative approach for lead insertion in children, avoiding venous access complications and right ventricular stimulation, without compromising sporting or musical activities. We analyzed the survival and performance of left atrial and left ventricular epicardial pacing leads, and present mid-term follow-up data.

Methods: Seventy-five bipolar steroid eluting pacing leads (Medtronic CapSure Epi 4968) were implanted in 41 children, aged 8.