{"title":"Paced QRS Duration and Morphology by Right Ventricular Inflow Tract Mid-Septal Lead Placement Using a 3D Stylet.","authors":"Tomomasa Takamiya, Akihiro Sato, Kensuke Fujiwara, Takashi Miyamoto, Makoto Mutoh, Shinsuke Miyazaki, Tetsuo Sasano","doi":"10.1111/pace.15201","DOIUrl":null,"url":null,"abstract":"<p><p>Paced QRS duration ≥150 ms is associated with pacing-induced cardiomyopathy (PICM). However, there is no established method for conventional stylet-driven pacing lead placement to achieve a narrow QRS duration. We placed a pacing lead on the right ventricular inflow tract (RVIT) mid-septum using a manually shaped three-dimensional (3D) stylet and three-directional fluoroscopic guidance in 9 consecutive patients with complete or advanced atrioventricular block and normal left ventricular systolic function. The median paced QRS duration was 140 (range, 122-153) ms, with a paced QRS duration <150 ms in 8 patients. The left superior axis and transitional zone of lead-V5 or lead-V6 were the most paced QRS morphologies. RVIT mid-septal lead placement using a 3D stylet with three-directional fluoroscopic guidance may reduce the incidence of PICM.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pace-Pacing and Clinical Electrophysiology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1111/pace.15201","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Paced QRS duration ≥150 ms is associated with pacing-induced cardiomyopathy (PICM). However, there is no established method for conventional stylet-driven pacing lead placement to achieve a narrow QRS duration. We placed a pacing lead on the right ventricular inflow tract (RVIT) mid-septum using a manually shaped three-dimensional (3D) stylet and three-directional fluoroscopic guidance in 9 consecutive patients with complete or advanced atrioventricular block and normal left ventricular systolic function. The median paced QRS duration was 140 (range, 122-153) ms, with a paced QRS duration <150 ms in 8 patients. The left superior axis and transitional zone of lead-V5 or lead-V6 were the most paced QRS morphologies. RVIT mid-septal lead placement using a 3D stylet with three-directional fluoroscopic guidance may reduce the incidence of PICM.
期刊介绍：
Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.
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