14th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 2000

Jan. 29 - Feb. 5, 2000
Marilleva, Trento, Italy

RT-98

Implantation of the passive fixation endocardial atrial lead in patients after CABG

Michal Chudzik, Jerzy Krysztof Wranics, Janusz Zrobek, Karol Bartczak, Janusz Kawinski.
Department of Cardiology, Institute of Cardiology, Medical Academy, Lodz, Poland

Introduction

The right atrial appendage is a small muscular extension of the right atrium, which overlaps the anterior surface of the aortic root as it projects upward and to the left, but it tends to be shorter over the age of 70¹. During open heart surgery the right atrial appendage is often amputated in order to establish cardiopulmonary bypass. Then the fixation of the J-shaped atrial passive fixation lead is difficult. Because of the risk a lead displacement, the use of active fixation atrial leads have been recommended in patients with previous open heart surgery who require permanent atrial or dual chamber pacing^2,3. However, unfavorable experiences with these leads: increasing pacing threshold^4,5, and opportunity of complications^6,7, sometimes very dangerous^8,9, force to considerate implantation of atrial passive fixation leads in patients with previous open heart surgery. We report acute and chronic performance of passive fixation atrial lead in 38 patients – 20 without open heart surgery and 18 patients after right atrial appendage amputation.