Chun-Heng Gao1, Hua Zhang, Jun-You Cui, Da-Zhong Zou. 1. Department of Echocardiography, Affiliated Jiangyin Hospital of South-East University Medical College, 163 Shou-Shan Road, Jiangyin, Jiangsu 214400, People' s Republic of China. gaochh@yahoo.com
Abstract
OBJECTIVE: To investigate the feasibility of determination of right ventricular outflow tract (RVOT) high septal pacing site visualized by real-time three-dimensional echocardiography (RT3DE). METHODS: The forty subjects with RVOT pacing were analysed. RT3DE determination of RVOT high septal pacing sites was compared with chest X-ray (CXR). RESULTS: RVOT septal pacing sites could be obtained in all patients by RT3DE.When pacing sites were categorized as septal or non-septal, there were good agreements between echocardiography and CXR (kappa = 0.745). However, when RVOT pacing sites were categorized as high septal or non-high septal in identifying the exact anatomic location of pacing sites, there was only mild agreement between echocardiography and CXR (kappa = 0.275). Moreover, when RT3DE was used as the gold standard in identifying the exact anatomic location of RVOT, pacing at the RVOT high septal could only be achieved in 37.5% (n= 15) of patients using RT3DE, but in 65% (n= 26) using CXR, because the RVOT septal pacing lead tip found at high septal by CXR is actually found at low septal or free wall by RT3DE. CONCLUSION: It is limited to accurately locate RVOT high septal pacing site only by CXR, RT3DE allows to determinate the RVOT high septal pacing sites helpfully.
OBJECTIVE: To investigate the feasibility of determination of right ventricular outflow tract (RVOT) high septal pacing site visualized by real-time three-dimensional echocardiography (RT3DE). METHODS: The forty subjects with RVOT pacing were analysed. RT3DE determination of RVOT high septal pacing sites was compared with chest X-ray (CXR). RESULTS: RVOT septal pacing sites could be obtained in all patients by RT3DE.When pacing sites were categorized as septal or non-septal, there were good agreements between echocardiography and CXR (kappa = 0.745). However, when RVOT pacing sites were categorized as high septal or non-high septal in identifying the exact anatomic location of pacing sites, there was only mild agreement between echocardiography and CXR (kappa = 0.275). Moreover, when RT3DE was used as the gold standard in identifying the exact anatomic location of RVOT, pacing at the RVOT high septal could only be achieved in 37.5% (n= 15) of patients using RT3DE, but in 65% (n= 26) using CXR, because the RVOT septal pacing lead tip found at high septal by CXR is actually found at low septal or free wall by RT3DE. CONCLUSION: It is limited to accurately locate RVOT high septal pacing site only by CXR, RT3DE allows to determinate the RVOT high septal pacing sites helpfully.