The Right Ventricular Outflow Tract as an Alternative Permanent Pacing Site: Long‐Term Follow‐Up

Abstract
The long‐term characteristics of the right ventricular outflow tract have been assessed as an alternative permanent pacing site to the right ventricular apex. Thirty‐three consecutive patients requiring ventricular pacing were randomized to be paced from one of the two sites. Pacing was performed using a screw‐in lead, and a programmable pacemaker was used to facilitate threshold testing. There was no significant difference in the lead positioning time or any acute implant measurement (e.g., threshold at 0.5 msec 0.4 ± 0.2 V for both sites, P = 0.99). Chronic measurements were also comparable during follow‐up (mean 73 months) with a mean threshold at most recent follow‐up of 0.15 ± 0.2 msec (apex) and 0.13 ± 0.21 msec (outflow tract) at 5 V, P = 0,81, There was only one pacing related complication, a lead dislodgment (outflow tract) in a pacemaker twiddler. Overall, both sites were highly satisfactory.

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