Implantation of additional defibrillation lead into the coronary sinus: an effective method of decreasing defibrillation threshold.

We report a case of successful implantation of an additional defibrillation lead into the coronary sinus due to high defibrillation threshold (DFT) in a seriously ill patient with a history of extensive myocardial infarction referred for implantable cardioverter- defibrillator implantation after an episode of unstable ventricular tachycardia. All previous attempts to reduce DFT, including subcutaneous electrode implantation, had been unsuccessful.

Survival analysis in patients with preserved left ventricular function and standard indications for permanent cardiac pacing randomized to right ventricular apical or septal outflow tract pacing.

Background: Optimal right ventricular (RV) pacing site in patients referred for permanent cardiac pacing remains controversial. A prospective randomized trial was done to compare long-term effect of permanent RV apex (RVA) vs RV outflow tract (RVOT) pacing on the all-cause and cardiovascular mortality.

Methods And Results: A total of 122 consecutive patients (70 men, 69 +/-11 years), with standard pacing indications were randomized to RVA (66 patients) or RVOT (56 patients) ventricular lead placement.

[Cardioverter-defibrillator implantation in a patient with persistent left superior vena cava--a case report].

A case of a successful implantation of cardioverter-defibrilator using the persistent left superior vena cava is presented. After six month of follow-up pacing and sensing parameters remained constant.

Right ventricular apex versus right ventricular outflow tract pacing: prospective, randomised, long-term clinical and echocardiographic evaluation.

Introduction: In patients treated with permanent pacing, the electrode is typically placed in the right ventricular apex (RVA). Published data indicate that such electrode placement leads to an unfavourable ventricular depolarization pattern, while right ventricular outflow tract (RVOT) pacing seems to be more physiological.

Aim: To compare long-term effects of RVOT versus RVA pacing on clinical status, left ventricular (LV) function, and the degree of atrioventricular valve regurgitation.

Biventricular pacing demonstrates similar effects in elderly and younger patients with advanced heart failure in the mid-term follow-up.

Background: Biventricular (BIV) pacing has been shown to improve haemodynamics and functional status of patients (pts) with advanced chronic heart failure (CHF). No study has determined the effects of BIV in relation to the age of pts.

Aim: To compare the clinical outcome in two groups of pts: > or =65 years (yrs) and <65 yrs referred for BIV pacing in our centre with at least 6 months of follow-up.