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Review
. 2022 Jun;33(2):181-185.
doi: 10.1007/s00399-022-00868-6. Epub 2022 May 24.

Anatomy for atrial lead implantation

Carsten W Israel  1 , Sona Tribunyan  2 , S Yen Ho  3 , José A Cabrera  4
Affiliations
Review

Anatomy for atrial lead implantation

Carsten W Israel et al. Herzschrittmacherther Elektrophysiol. 2022 Jun.

Abstract
in English, German

Positioning and fixation of pacemaker leads in the right atrium depends on advanced anatomic knowledge in order to correctly interpret information from fluoroscopy and electrograms. Particularly the inability to reach a certain position or to achieve lead stability requires familiarity with right atrial structures such as the Eustachian ridge or areas of trabeculated versus smooth myocardium. Only a good understanding of right atrial anatomy makes it possible to replace electrophysiologically suboptimal atrial pacing sites such as right atrial appendage or high lateral wall by electrophysiologically better septal atrial pacing sites.

Positionierung und Fixierung von Schrittmacherelektroden im rechten Atrium erfordern gute anatomische Kenntnisse, um die fluoroskopischen und elektrographischen Informationen richtig interpretieren zu können. Insbesondere wenn sich eine gewünschte Position oder eine Elektrodenstabilität nicht erreichen lässt, sind Kenntnisse über rechtsatriale Strukturen wie die Eustach’sche Klappe oder über Areale mit trabekularisiertem vs. glattem Myokard erforderlich. Erst gute Kenntnisse der rechtsatrialen Anatomie erlauben es, als Standard bei atrialer Stimulationsnotwendigkeit eine elektrophysiologisch eher ungünstige Elektrodenimplantation im rechten Vorhofohr oder hochlateral durch eine günstigere septale Elektrodenfixierung zu ersetzen.

Keywords: Bachmann’s bundle; Pacemaker; Right atrial appendage; Right atrium; Septal pacing.

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References

    1. Danish Pacemaker and ICD Register (2019) Annual report. https://www.sundhed.dk/content/cms/21/109821_dpir_annual_report_2019_fin... . Accessed 12 May 2022
    1. Healey JS, Israel CW, Connolly SJ, Hohnloser SH, Nair GM, Divakaramenon S, Capucci A, Van Gelder IC, Lau CP, Gold MR, Carlson M, Themeles E, Morillo CA (2012) Relevance of electrical remodeling in human atrial fibrillation: results of the Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial mechanisms of atrial fibrillation study. Circ Arrhythm Electrophysiol 5:626–631 - DOI
    1. Israel CW, Burmistrava T, Berger C (2018) Bachmann bundle pacing. Herz 43:584–595 - DOI
    1. Markewitz A (2021) Annual report 2019 of the German pacemaker and defibrillator registry-part 1: cardiac pacemakers. Herzschrittmacherther Elektrophysiol 32:510–523 - DOI
    1. Markewitz A (2021) Annual report 2019 of the German pacemaker and defibrillator registry-part 2: implantable cardioverter-defibrillators (ICD). Herzschrittmacherther Elektrophysiol 32:524–540 - DOI

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