+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Implantation of permanent pacemaker and ICD leads in children using a three-dimensional electroanatomic mapping system as an aid to fluoroscopy



Implantation of permanent pacemaker and ICD leads in children using a three-dimensional electroanatomic mapping system as an aid to fluoroscopy



Pacing and Clinical Electrophysiology 38(4): 448-454



Three-dimensional electroanatomic mapping systems (3D mapping) allow the creation of an anatomic representation of the cardiac anatomy and real-time monitoring of transvenous pacing catheters. Their use to facilitate pacemaker (PM) and implantable cardioverter defibrillator (ICD) lead placement in the pediatric population has not been well defined. We sought to review our experience using 3D mapping as an adjunct to fluoroscopy for positioning of permanent PM and ICD leads in pediatric patients. We performed a retrospective review of all patients ≤21 years of age who underwent PM or ICD implantation with the aid of the Ensite Velocity system (Ensite) from May 2012 to September 2014. Fluoroscopy was utilized in addition to 3D mapping to aid obtaining vascular access, to visualize fixation of the lead to the myocardium, and to evaluate lead length within the vasculature. Nineteen patients (mean age 14.6 ± 4.4 years) underwent placement of active fixation PM leads (N = 17) and/or ICD leads (N = 10) with the aid of Ensite. All leads were successfully placed (eight atrial, 19 ventricular). Fluoroscopic exposure was a mean of 3.2 minutes (± 2.8, 0.1-10.5). There was one lead dislodgement. Ensite was used successfully as an adjunct to fluoroscopy in all patients in whom it was attempted to aid the placement of permanent transvenous PM and ICD leads. Future evaluation could focus on the use of 3D mapping systems to further minimize or eliminate fluoroscopy from PM and ICD implantations.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 058066856

Download citation: RISBibTeXText

PMID: 25652679

DOI: 10.1111/pace.12579


Related references

Atrioventricular node ablation and permanent ventricular pacemaker implantation without fluoroscopy: use of an electroanatomic navigation system. Journal of Cardiovascular Electrophysiology 16(7): 793-795, 2005

Utility of the NavX® Electroanatomic Mapping System for Permanent Pacemaker Implantation in a Pregnant Patient with Chagas Disease. Indian Pacing and Electrophysiology Journal 13(1): 34-37, 2013

Near-zero fluoroscopy implantation of dual-chamber pacemaker in pregnancy using electroanatomic mapping. Heartrhythm Case Reports 3(4): 205-209, 2017

Implantation of a dual-chamber permanent pacemaker in a pregnant patient guided by intracardiac echocardiography and electroanatomic mapping. Heartrhythm Case Reports 3(11): 542-545, 2017

Transvenous nonfluoroscopic pacemaker implantation during pregnancy guided by 3-dimensional electroanatomic mapping. Heartrhythm Case Reports 3(10): 490-492, 2017

Cardiac Resynchronization Therapy-Pacemaker Implantation Guided by Three-Dimensional Electroanatomic Mapping for a Chinese Young Man with Danon Disease. Chinese Medical Journal 131(22): 2760-2762, 2018

Low Fluoroscopy Permanent His Bundle Pacing Using Electroanatomic Mapping. Circulation. Arrhythmia and Electrophysiology 12(2): E006967, 2019

Zero-fluoroscopy permanent pacemaker implantation using Ensite NavX system: Clinical viability or fanciful technique?. Pacing and Clinical Electrophysiology 41(2): 122-127, 2017

Implantation of single-lead atrioventricular permanent pacemakers guided by electroanatomic navigation without the use of fluoroscopy. Europace 10(9): 1048-1051, 2008

Reduction of radiation exposure during atrial fibrillation ablation using a novel fluoroscopy image integrated 3-dimensional electroanatomic mapping system: A prospective, randomized, single-blind, and controlled study. Heart Rhythm 12(9): 1945-1955, 2016

Three-Dimensional Electroanatomic Mapping System-Enhanced Cardiac Resynchronization Therapy Device Implantation: Results From a Multicenter Registry. Journal of Cardiovascular Electrophysiology 28(1): 85-93, 2016

X-ray-free implantation of a permanent pacemaker during pregnancy using a 3D electro-anatomic mapping system. European Heart Journal 36(41): 2790, 2016

Feasibility, accuracy, and safety of 3-dimensional electroanatomic mapping without fluoroscopy in patients with congenital heart defects. Heart Rhythm 13(8): 1667-1673, 2018

Cardiac three-dimensional magnetic resonance imaging and fluoroscopy merging: a new approach for electroanatomic mapping to assist catheter ablation. Circulation 112(24): 3769-3776, 2005

Electroanatomic mapping-guided catheter ablation of atrial tachycardia in children with limited/zero fluoroscopy. Pacing and Clinical Electrophysiology 2019, 2019