Using the Surface ECG to Identify Right Ventricular Pacing Lead Position: A Cautionary Tale |
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| Authors: | GERALD C KAYE MBChB MD MATTHEW K ROWE MBBS BSc PAUL A GOULD MBBS PhD |
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| Institution: | 1. Department of Cardiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia;2. The School of Medicine, University of Queensland, Brisbane, Queensland, Australia |
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| Abstract: | Chronic right ventricular (RV) apical pacing may lead to the development of heart failure in some patients. Although pacing of the RV septum has been proposed as an alternative, positioning a lead in the true septum has proven challenging. In addition to fluoroscopy at implant, it has been suggested that 12‐lead surface electrocardiogram (ECG) can be used to determine septal lead position; however, studies show this may be inaccurate. We present a case where a change in the ECG QRS axis late after pacemaker insertion with an active fixation lead highlights the difficulties of ECG localization of pacing leads. |
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| Keywords: | pacing electrocardiogram septal pacing |
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