Biventricular pacing systems

The book is divided into four sections. The first section describes pacing leads and pacemaker function. The second section focuses on device implantation. New to this edition is a chapter on implantation of left ventricular leads, used in the biventricular pacing systems intended to treat patients with heart failure. Purposely we have asked two experienced implanters to discuss then-personal methods for placing leads in the cardiac venous systems to illustrate the diversity of techniques and tricks of the trade. The third section reviews the use of implantable cardiac devices in particular clinical situations. All of the chapters from the first edition have been extensively revised new to this edition are chapters on device use for patients with atrial fibrillation, heart failure, and syncope, providing further evidence for the expanding indications... 

Duray GZ, Israel CW, Pajitnev D, Hohnloser SH. Upgrading to biventricular pacing/defibrillation systems in right ventricular paced congestive heart failure patients prospective assessment of procedural parameters and response rate. Europace 2008 10 48-52. 

Some authors recommend contralateral reimplantation as early as 36 h after extraction in patients with local symptoms only of device-related infection [10]. In some instances, it is considered safe to perform a contralateral same-day reimplantation [11]. The reasons for a same-day reimplantation are usually pacemaker (PM) dependency or hemodynamic need for CRT in case of biventricular pacing. In fact, the risk of subsequent CIED infections and venous thrombosis increases while maintaining a transvenous temporary device, and for this reason, it cannot be used indefinitely [12]. Same-day reimplantation is considered safe if the patient is clinically proven not to have active systemic bacteremia or infection by blood culture at the time of extraction and there is a lack of transesophageal echocardiographic evidence for endocarditis and the presence of a normal white blood cell count. 

Table 4.19 Upgrading tecbniques for biventricular pacing and ICD systems.

This chapter will review multiple aspects and techniques associated with the routine follow-up of the pacing system including biventricular systems. 

Kleine P, Gronefeld G, Dogan S et al. Robotically enhanced placement of left ventricular epicardial electrodes during implantation of a biventricular implantable cardioverter defibrillator system. PACE 2002 25 989-991. 

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