Journal of Electrocardiology
Volume 43, Issue 2 , Pages 136-141, March 2010

Effects of left ventricular lead positions and coronary venous microanatomy on cardiac pacing parameters☆

  • Sara E. Anderson, PhD
    • ,
  • Paul A. Iaizzo, PhD

      Affiliations

    • Corresponding Author InformationCorresponding author. Department of Surgery, University of Minnesota, B172 Mayo, MMC 195, 420 Delaware Street SE, Minneapolis, MN 55455, USA.

Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA

Department of Surgery, University of Minnesota, Minneapolis, MN, USA

Received 29 May 2009 published online 16 September 2009.

Abstract 

We describe effects of pacing lead position and cardiac microanatomy on electrical pacing parameters. Passive fixation transvenous pacing leads were implanted in anterior interventricular veins in isolated swine hearts (n = 6). Electrical pacing parameters were measured in 3 implant positions (5 implant sites each): touching myocardial side of venous wall, not touching venous wall, and touching epicardial side of venous wall. After perfusion fixing hearts, veins were sectioned perpendicular to vein's length from base to apex. Slides were prepared and analyzed for measurement of vein wall thickness/circumference, and distances between vein walls and myocardium. Average pacing thresholds were greater when pacing leads were free-floating (5.45 ± 3.29 V) or oriented in epicardial positions (6.81 ± 2.96 V) compared with myocardial positions (3.79 ± 3.46 V; P = not significant). Vein circumferences were significantly larger in basal regions (8.31 ± 2.28 mm) compared with mid (6.90 ± 1.46 mm) and apical (6.40 ± 1.92 mm) regions (P < .05). Variability in pacing thresholds and impedances indicates that pacing lead placement in left ventricular coronary veins significantly affects electrical pacing parameters.

Keywords: Coronary veins, Pacing threshold, Pacing impedance, Microanatomy, Left ventricle

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☆ Financial support: This work was supported by Medtronic, Inc, and the Institute for Engineering in Medicine, University of Minnesota.

PII: S0022-0736(09)00372-0

doi:10.1016/j.jelectrocard.2009.08.002

Journal of Electrocardiology
Volume 43, Issue 2 , Pages 136-141, March 2010

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