The fluoroscopic index common to the lead in the right ventricular
lateral free wall:A report of three cases
Abstract
It has been reported that the prevalence of cases whose leads were
located in the right ventricular lateral wall (RVLW), even though we
intended to implant the leads in the right ventricular septum (RVS), is
not uncommon. Among the cases whose leads were assumed to be implanted
in the RVS, we experienced three cases whose leads were confirmed to be
located in the RVLW by postoperative CT. We investigated the
intra-operative fluoroscopic index common to these three leads. In the
left anterior oblique view (LAO), the transverse movement of the
lead-tip seemed to be exceptionally large in all cases. To assess this
index, we compared to the consecutive twenty leads confirmed to be
located in the RVS. The transverse movement of the lead-tip in the RVLW
was clearly greater than that in the RVS (12.8±1.7 mm vs. 4.2±0.9 mm).
This difference was large enough to be judged visually. Large transverse
movement of the lead-tip in LAO may be a new visual fluoroscopic index
that predicts anchoring to the RVLW.