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1、REVIEWAdvancesinCardiacPacing:BeyondtheTransvenousRightVentricularApicalLeadSurajKapa,1CharlesJ.Bruce,2PaulA.Friedman2&SamuelJ.Asirvatham2,31DepartmentofMedicine,MayoClinic,Rochester,MN,USA2DivsionofCardiovascularDiseases,DepartmentofMedicine,MayoClinic,Rochester,MN
2、,USA3DivisionofPediatricCardiology,DepartmentofPediatricsandAdolescentMedicine,MayoClinic,Rochester,MN,USAKeywordsWhilefordecadesrightventricular(RV)apicalpacinghasbeenthestandardCardiacpacing;Intramyocardialelectrodes;ofcareforpatientsrequiringpacemakerordefibrillat
3、orleadplacement,inves-Leadlesspacing;Selective-sitepacing.tigatorshavesoughtalternativestoachievemorephysiologicelectricalacti-vationoftheheartandreducelong-termpathologiceffectsofnonphysiologicCorrespondenceapicalpacing.Theseinvestigationshaveincludedattemptsatiden
4、tifyingsu-SamuelJ.Asirvatham,M.D.,DivisionofCardiovascularDiseases,DepartmentofInternalperiorpacingsiteswithintherightatriumandRVanddevelopmentofnewMedicineandDivisionofPediatricCardiology,leadstoenhancespecificityofsensingandcapture.Thisreviewfocusesonre-Departmento
5、fPediatricandAdolescentcentadvancesinalternativesitesforpacinganddevelopmentsinnovelpacingMedicineMayoClinicCollegeofMedicine,technologyrangingfromintramyocardialelectrodestoleadlesspacemakers.200FirstStreet,SWRochester,MN55905,USA.First,therehavebeenseveralstudiesd
6、emonstratingpotentialbenefitsofsite-Tel.:507-255-2440;specificpacing,includingHisbundlepacingandRVoutflowtractpacinginFax:507-255-2550;potentiallyattenuatingelectromechanicaldyssynchronyandlong-termfunc-E-mail:asirvatham.samuel@mayo.edutionaldeclineseenwithRVapicalpaci
7、ng.Availableoptionsforleadplace-menthavebeenenhancedbydevelopmentofintramyocardialelectrodesthatmaysignificantlyreducefar-fieldoversensingandnonchamberspecificcap-doi:10.1111/j.1755-5922.2010.00157.xture.Withdevelopmentofintramyocardialelectrodes,thepotentialforatri-ov
8、entricularseptalpacinghasrecentlybeendescribed,makingsynchronousactivationofbothventricleswithaone-leadsystempossiblewithoutcrossingthetri
