Paced QRS Duration and Morphology by Right Ventricular Inflow Tract Mid‐Septal Lead Placement Using a 3D Stylet
- 12 May 2025
- journal article
- Published by Wiley in Pacing and Clinical Electrophysiology
- Vol. 48 (6) , 644-648
Abstract
Paced QRS duration ≥150 ms is associated with pacing‐induced cardiomyopathy (PICM). However, there is no established method for conventional stylet‐driven pacing lead placement to achieve a narrow QRS duration. We placed a pacing lead on the right ventricular inflow tract (RVIT) mid‐septum using a manually shaped three‐dimensional (3D) stylet and three‐directional fluoroscopic guidance in 9 consecutive patients with complete or advanced atrioventricular block and normal left ventricular systolic function. The median paced QRS duration was 140 (range, 122–153) ms, with a paced QRS duration <150 ms in 8 patients. The left superior axis and transitional zone of lead‐V5 or lead‐V6 were the most paced QRS morphologies. RVIT mid‐septal lead placement using a 3D stylet with three‐directional fluoroscopic guidance may reduce the incidence of PICM.Keywords
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