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Europace 2000 2(3):233-239; doi:10.1053/eupc.2000.0106
© 2000 by European Society of Cardiology
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Initial United Kingdom experience with the use of permanent, biventricular pacemakers

Implantation procedure and technical considerations

S. Walker, T. Levy, S. Rex, S. Brant and V. Paul

Department of Cardiology, Harefield Hospital Middlesex, U.K.

AIMS: To describe the institution of a biventricular pacing programme with particular reference to the implantation procedure and new technological considerations.

METHODS AND RESULTS: Analysis of outcomes of a consecutive series of 54 patients undergoing attempted biventricular pacemaker implantation between February 1998 and April 1999. Successful implantation was achieved in 49 of the 54 patients (91%). Five patients required lead repositioning after initial successful implantation. Left ventricular lead pacing thresholds were found to be satisfactory and stable in the long term, with pacing thresholds of 1·3 V, 1·9 V and 1·6 V at implantation, 1 and 3 months, respectively. Left-sided lead function was not dependent on lead position within the tributaries of the coronary sinus. The implantation procedure was found to be safe, although one patient died during long-term follow-up.

CONCLUSION: With appropriate previous experience in complex and coronary sinus pacing and with access to up-to-date pacemaker and lead technology, a biventricular pacemaker implantation service can be instituted with good medium-term results.

Key Words: Biventricular pacemaker, heart failure

Correspondence: Dr S. Walker, Department of Cardiology, Harefield Hospital, Royal Brompton and Harefield NHS Trust, Harefield, Middlesex UB9 6JH, UK


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