Right ventricle outflow tract

Fig. 4.100 Anteroposterior view of the right ventricle. The right ventricular outflow tract has been divided into four segments two on the septum and two on the free wall. PACE 27 884, 2004 part 11. (from Lieberman R, Grenz D, Mond HG et al Selective site pacing defining and reaching the selected site. PACE 27 884, 2004)...

Fig. 16.6 The paced QRS complexes in this 12-lead ECG have an inferiorly directed mean frontal plane axis, and a left bundle branch block pattern. This suggests that pacing is occurring in the right ventricle, from the area of the outflow tract or high septum. This position is not associated with pacing function instability in permanent systems in temporary pacing systems, however, right ventricular outflow tract lead position is not stable and revision is required.

The three discrete potential maxima (50 ms) reflect activation fronts in three regions of the heart. From left to right right ventricular outflow tract anterior wall of left ventricle posterior wall of left ventricle. 

The cardiac outflow tract extends from the ventricle and is apparent on the anatomical right side of the embryo. When it is in its correct orientation, the outflow tract should resemble the letter C or U in appearance (Fig. 9a, dotted line). 

Fig. 9. Fleart evaluation, (a) Normal heart viewed from the anatomical right side of the embryo. The outflow tract forms a C" or a U shape (dotted line). TA— truncus arteriosus CC—conus cordis BC—bulbus cordis, (b) Normal heart viewed from anatomical leftside of the embryo. V—ventricle A—atrium. The two chambers form a peanut shape (dotted line) with the ventricle appearing slightly larger than atrium.

Fig. 10. Representative score assignment for heart, (a) Left side of a heart with normal ventricle and atrium, (b) Ventricle slightly small but within normal range (c) Delineation between ventricle and atrium chambers is not clear. An abnormal dark/dense tissue in the ventricle chamber (arrowy, (d) Both ventricle and atrium chambers have blood congestion and are small. An enlarged and translucent outflow tract is observed above the chambers (arron. (e) Small chambers with abnormal orientation and a very short outflow tract (arron. (f) Right side of a normal heart with normal U shaped outflow tract dotted iine). (g) Outflow tract slightly narrowed (arrows), (h) A kink formed in outflow tract dotted tine), (i) Outflow tract very short and narrow with a kink dotted tind). Q) Abnormally shaped and shortened outflow tract dotted tine).

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