Interatrial septum pacing guided bythree-dimensional intracardiac echocardiography
Tamas Szili-Torok, MD*,*,
Geert-Jan P. Kimman, MD*,
Marcoen F. Scholten, MD*,
Jurgen Ligthart*,
Nico Bruining, PhD*,
Dominic A. M. J. Theuns, MSc*,
Peter J. Klootwijk, MD, PhD*,
Jos R. T. C. Roelandt, MD, PhD, DSc, FACC* and
Luc J. Jordaens, MD, PhD*
* Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
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Figure 1 An "en face" view of the interatrial septum (IAS) before (A, B) and after (C, D) pacemaker lead implantation. The fossa ovalis (FO) is clearly visible in both situations. Arrows (A, B) show the selected spot for pacing of the IAS. A virtually perfect positioning of the atrial lead was achieved in this case, as the arrow on panels C and D indicate the cross-section of the atrial lead in front of the anterior-superior edge of the muscular interatrial septum and the membrane of FO. The achieved spot is identical to the desired spot shown by two-dimensional and three-dimensional images.
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Figure 2 A longitudinal cross-sectional (A) and a real three-dimensional image (B) reconstructed from a volumetric data set with a schematic representation (C) shows the right atria (RA) and left atria (LA) in a patient after suprafossal pacing. In this case the fossa ovalis (FO) is placed fairly downward. Ao = aorta; CT = crista terminalis; IVC = inferior vena cava; SVC = superior vena cava.
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