OPTIMAL APPROACH FOR ATRIAL EPICARDIAL ELECTRODE IMPLANTATION

Abstract

Theoretical benefits afforded by P-synchronous, atrial and A -V sequential pacing have been recognized before. However, historical difficulties associated with achieving and maintaining atrial lead position and low electronic pacing system reliability in comparison to ventricular systems have resulted in a low utilization of atrial systems. But recent reports in the medical literature suggest that reliable, practicable atrial pacing systems and surgical approaches to the atrim may now be available.
We performed the right parasternal approach to apply atrial sensing, pacing to three patients. We advocate this approach for permanent physiologic pacing since it permited easy mediastinal entry without entering pleura and a wider exposure of accessible atrial sensing, pacing sites.