Journal of Clinical Case Reports

Hirooki Inui

Publications

• Case Report
  Pacemaker Lead Perforation during Right Ventricular Outflow Tract Pacing-Importance of Heart Rotation at Pacemaker Implantation
  Author(s): Tetsuya Watanabe, Yukinori Shinoda, Kuniyasu Ikeoka, Hidetada Fukuoka, Hirooki Inui, Masaaki Uematsu and Shiro HoshidaTetsuya Watanabe, Yukinori Shinoda, Kuniyasu Ikeoka, Hidetada Fukuoka, Hirooki Inui, Masaaki Uematsu and Shiro Hoshida
  
  A 70 year-old woman underwent a dual-chamber pacemaker implantation for episodes of transient block and syncope. The transitional zone of her ECG was observed between V4 and V5, indicating clockwise rotation. An experienced physician performed the Right Ventricular Outflow Tract (RVOT) pacing using an active fixation lead without any immediate complications. For RVOT pacing, the lead was placed approximately two-thirds of the distance from the apex to the pulmonary valve in the postero-anterior view and pointing towards the septum in the left anterior oblique view. The ECG revealed a narrow QRS (120 msec) and the lead I morphology was minus-plus. Six days post-implant, a pacemaker interrogation revealed ventricular undersensing and loss of capture with high output pacing. Chest computed tomography revealed the left ventricle was displaced to the left and the left-sided angle between t.. Read More»
  DOI: 10.4172/2165-7920.1000707

  Abstract PDF