The Placement of Atrial Pacing Leads in Patients after Cardiac Surgery

Slides:

Advertisements

Similar presentations

Linoxsmart S DX Master Study

Advertisements

Modes of Pacing Seoul National University Hospital

Congenital Heart Disease: Outcome in Patients with Single Ventricle

Jennifer Cohen, MD, Heather Costa, PhD, Robert Russo, MD, PhD, Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA The MagnaSafe Registry:

How to Handle Lead Problems in Pediatric & Congenital Heart Disease

Boston Children’s Hospital, Harvard Medical School

ACHD Patients Should Receive Treatment in Adult Institutions Society of Thoracic Surgeons Adult Cardiac Surgery Database reports 39,872 adults undergoing.

Heart Transplantation for Patients with a Fontan Procedure

Current Status and Prospect of Interventional Congenital Heart Disease

TAVR Pearls Addressing the Shortcomings of the Current TAVR Generation

Impact of Concomitant Tricuspid Annuloplasty on Tricuspid Regurgitation Right Ventricular Function and Pulmonary Artery Hypertension After Degenerative.

Alpay Celiker M.D. Acıbadem University.  Advances in lead and device technology allow pacemaker system implantation in children and even in neonates.

MCS in Special Populations: The Use of Mechanical Support in Adults with Congenital Heart Disease 9 th Annual Meeting May 15, 2015 Christina VanderPluym,MD.

Pulmonary Atresia with Intact Ventricular Septum Ali Sepahdari, MD University of Illinois at Chicago.

The Atrioventricular Block in pediatric cardiology Coordinator: Dr. GOZAR LILIANA Author: BENTZ OANA.

Author: Denisa Pop 1 Second Authors: Dominic Pascal Keller 1 Roxana Costache 1 Tamas Szabo 1 Coordinators: Medical Doctor Valentin Stroe 2 Professor Horatiu.

Cardiothoracic Surgery. Topics Valvotomy and valve replacement Open heart surgery and cardiac bypass surgery Correction of congenital heart diseases Heart.

Percutaneous Establishment of Tricuspid Regurgitation: An Experimental Model for Transcatheter Tricuspid Valve Replacement Yuan Bai, Gang-jun Zong, Yong-wen.

Presenter: Shoujun Li, Kai Ma Department of Pediatric Cardiac Surgery, Fuwai hospital & National Center for Cardiovascular Disease, PUMC&CAMS, Beijing,

Surgically-BasedDevice VSD Closure Olaf Wendler Department of Cardiothoracic Surgery King‘s College Hospital.

EVEREST II Study Design Multicenter Randomized in a 2:1 ratio to either percutaneous or conventional surgery for the repair or replacement of the mitral.

Adult with operated congenital heart disease: what should we check for? January 15 th, h-17h30.

H. Amoozgar, MD Professor of pediatric cardiology Shiraz University of Medical Sciences, Shiraz, Iran TRANSCATHETER CLOSURE OF LARGE CORONARY-CAMERAL FISTULAE.

Marc G Cribbs, MD Director, Alabama Adult Congenital Heart Program University of Alabama at Birmingham Children’s of Alabama Alabama Adult Congenital Heart.

Date of download: 6/24/2016 Copyright © The American College of Cardiology. All rights reserved. From: The Year in Cardiovascular Surgery J Am Coll Cardiol.

METHODS The EASYTRAK 2 lead was studied along with the CONTAK  RENEWAL  2/4/4HE device in the Device Evaluation of the CONTAK RENEWAL 2/4/4HE with EASYTRAK.

1 Heart surgery in Norway 2008 Norwegian Association of Cardiothoracic Surgeons Jan L.Svennevig, MD,PhD

Primary Mitral Regurgitation Degenerative Mitral Valve Disease

James S. Tweddell, MD Warren W. Bailey Endowed Chair,

Jan L.Svennevig, MD,PhD Heart surgery in Norway 2009 Norwegian Association for Cardiothoracic Surgery Jan L.Svennevig, MD,PhD.

Mitral Regurgitation: Epidemiology, Pathophysiology and When to Repair

Table 1 Cause of death for arrested organ donors

Is There a Need to Address AF in patients Undergoing Valve Surgery?

Jan L.Svennevig, MD,PhD Heart surgery in Norway 2005 Norwegian Association of Cardiothoracic Surgeons Jan L.Svennevig, MD,PhD.

57 (27%) limited or no EPI RFA 9 persistent bleeding after access

Jan L.Svennevig, MD,PhD Heart surgery in Norway 2006 Norwegian Association of Cardiothoracic Surgeons Jan L.Svennevig, MD,PhD.

Max B. Mitchell, MD The Journal of Thoracic and Cardiovascular Surgery

Mechanical circulatory support

Successful Cox Maze Procedure During Mitral Valve Surgery Restores Patient Survival Without Increasing Operative Risk Niv Ad, MD Chief, Cardiac Surgery.

Table 1 Baseline characteristics of mitral valve operated patientsaaAF, atrial fibrillation; LA, left atrium; LVEDD, left ventricular end-diastolic.

Jan L.Svennevig, MD,PhD Heart surgery in Norway 2007 Norwegian Association of Cardiothoracic Surgeons Jan L.Svennevig, MD,PhD.

Table 1 Recipient’s characteristics.

Fig. 3 Summary estimates of the relative risks for the different surgical techniques for late mortality. Comparing the two main techniques, EVR showed.

Lindsay S. Rogers, MD, Amy L. Peterson, MD, J

Double Switch Operation for Failing Systemic Ventricle

Emad B. Mossad, MD, Pablo Motta, MD, David F. Vener, MD

EKGs and Pacemakers Cooper University Hospital

Hemodynamics and myocardial blood flow patterns after placement of a cardiac passive restraint device in a model of dilated cardiomyopathy Jennifer A.

Jonathan M. Behar et al. JACEP 2016;2:

Jan L.Svennevig, MD,PhD Heart surgery in Norway 2004 Norwegian Association of Cardiothoracic Surgeons Jan L.Svennevig, MD,PhD.

Emad B. Mossad, MD, Pablo Motta, MD, David F. Vener, MD

Robotic-enhanced biventricular resynchronization: an alternative to endovenous cardiac resynchronization therapy in chronic heart failure Jean-Luc Jansens,

Enhancing the Value of Population-Based Risk Scores for Institutional-Level Use Sajjad Raza, MD, Joseph F. Sabik, MD, Jeevanantham Rajeswaran, PhD, Jay.

Load dependence of cardiac output in biventricular pacing: right ventricular pressure overload in pigs David G Rabkin, MD, Santos E Cabreriza, MBA, Lauren.

Comparison of longevity, pacing, and sensing characteristics of steroid-eluting epicardial versus conventional endocardial pacing leads in children Gertie.

Evaluation of right ventricular function after cardiac surgery: The importance of tricuspid annular plane systolic excursion and right ventricular ejection.

Erick M. Carreras, Walter J

Myriad manifestations of myxoma

Aditya K. Kaza, MD The Journal of Thoracic and Cardiovascular Surgery

Brian A. Bruckner, MD, Limael E

Intracardiac Migration of Operatively Placed Epicardial Pacing Leads

Transmural Placement of Endocardial Pacing Leads in Patients With Congenital Heart Disease Stany Sandrio, MD, Ariawan Purbojo, MD, Okan Toka, MD, Sven.

Henry M. Spotnitz, MD, Daniel Y. Wang, MD

A new method for implanting a total artifical heart in the patient with a Fontan circulation Ronald K. Woods, MD, PhD, Robert Niebler, MD, Steve Kindel,

Use of intracardiac echocardiography as a guide during interventricular septum puncture in a patient undergoing cardiac resynchronization therapy Manuel.

P.Michael McFadden, John L Ochsner The Annals of Thoracic Surgery

Daniel J Goldstein, MD, David Rabkin, MD, Henry M Spotnitz, MD

Anatomical variations on a univentricular circulation

OBJECTIVES At the conclusion of this session, students will be able to: Identify common types of congenital cardiac anomalies. Describe basic concepts,

Transcatheter versus medical treatment of symptomatic severe tricuspid regurgitation: a propensity score matched analysis Maurizio Taramasso MD, PhD from.

Presentation transcript:

The Placement of Atrial Pacing Leads in Patients after Cardiac Surgery Dept. of Cardiology, First Affiliated Hospital, Nanjing Medical University Jiangang Zou, M.D.; Ph.D.

Introduction The incidence of AVB and SND following open-heart surgery for congenital heart disease: 1%~4% The incidence of bradyarrhythmias after cardiac transplantation varies from 8% to 23% The experience of the permanent pacing after open-heart surgery is rare The placement of atrial pacing leads

Circulation 2008,117:e350-e408

Recommendations for permanent pacing in children, adolescents, and patients with congenital heart disease

Recommendations for permanent pacing in children, adolescents, and patients with congenital heart disease

Recommendation for pacing after cardiac transplantation

The implantation of pacing leads Transvenous: Cephelic/subclavian puncture/active lead Epicardial: small body size Fontan-type procedures tricuspid valve replacement The placement of atrial pacing leads

Europace 2007,9:426-31

Lead failures: EPI: 18% OF ATRIAL LEADS, 24% OF VENTRICULAR LEADS ENDO: 5% OF VENTRICULAR LEADS Single-lead, VVIR ENDO pacing had higher efficiency and safety than EPI.

Ann Thorac Surg. 2008;85(5):1704-11

239 bipolar steroid-eluting epicardial leads in 114 cases 12-year follow-up Average atrial and ventricular threshold:1.2V/0.5ms Thresholds of LA and RA: 0.82V/0.5ms and 0.74V/0.5ms Thresholds of LV and RV: 0.96V/0.5ms and 0.94V/0.5ms P sensing of LA and RA: 3.4mV and 2.9mV V sensing of LV and RV: 11.2mV and 7.7mV Lead failure: 19(8%) Lead survival at 2 and 5 year : 99% and 94% for atrial leads 96% and 85% for ventricular leads

Bipolar steroid-eluting epicardial leads demonstrate excellent sensing characteristics and persistent low pacing threshold

Eur J Cardiothorac Surg 2000;17:455-461

Transvenous pacing in the pediatric population is associated with a lower threshold and lower rate of lead-related complications If EPI lead necessary, steroid-eluting leads recommended

J Thorac Cardiovasc Surg 1999;117:523-528

Lead failure: 4 (epi) vs 4 (endo) Lead survival at 2 year: 91% (epi) vs 87% (endo)

Steroid-eluting epi leads have the same longevity as the conventional endo lead Pacing and sensing are similar Steroid-eluting epi leads are good alternatives for endo leads for small children

PACE 2009:32:779-785

Compared to epi lead, transvenous atrial pacing lead may be placed in Fontan patients with lower procedure morbidity and expectation of lead performance and longevity.

3 DDD cases after surgery atrial lead characteristics: sensing threshold impedance lead pt.1 at impant(17y) 4.5mv 0.6V/0.4ms 650 passive follow-up(4y) 2.5mv no capture 680 pt.2 at impant(34y) 2.2mv 0.5V/0.4ms 720 active follow-up(41y) 2.0mv 0.5V/0.4ms 700 pt.3 at impant(14y) 3.0mv 1.0V/0.4ms 690 active follow-up(3y) 2.5mv 1.2V/0.4ms 720

conclusions The placement of atrial lead: endocardial and epicardial Endocardial: screw-in, older children Epicardial: steroid-eluting lead recommended small body size Fontan-type procedures tricuspid valve replacement Follow-up

Thanks for your attention!