{"id":18784,"date":"2015-01-26T17:32:53","date_gmt":"2015-01-26T17:32:53","guid":{"rendered":"https:\/\/cardiophile.org\/?p=18784"},"modified":"2021-10-29T15:07:17","modified_gmt":"2021-10-29T09:37:17","slug":"cardiac-resynchronization-therapy-crt-x-ray","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/cardiac-resynchronization-therapy-crt-x-ray\/","title":{"rendered":"Cardiac resynchronization therapy (CRT) &#8211; X-ray"},"content":{"rendered":"<p><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/sOnUQNcgPNs\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<h3><span style=\"color: #008000;\">Cardiac resynchronization therapy (CRT) &#8211; X-ray<\/span><\/h3>\n<p><strong>Abstract:\u00a0<\/strong>Cardiac resynchronization therapy (CRT) is biventricular pacing in which one lead paces the right ventricle endocardialy, another the left ventricle epicardially through a coronary vein and a third paces the right atrial appendage. It is a mode of treatment of left ventricular failure due to cardiac dyssynchrony, usually with left bundle branch block and wide QRS complex.<\/p>\n<figure id=\"attachment_18785\" aria-describedby=\"caption-attachment-18785\" style=\"width: 532px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2015\/01\/crt.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-18785 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2015\/01\/crt.jpg\" alt=\"X-ray Chest in CRT showing pulse generator and three leads\" width=\"532\" height=\"450\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2015\/01\/crt.jpg 532w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2015\/01\/crt-300x254.jpg 300w\" sizes=\"auto, (max-width: 532px) 100vw, 532px\" \/><\/a><figcaption id=\"caption-attachment-18785\" class=\"wp-caption-text\">X-ray Chest in CRT showing pulse generator and three leads<\/figcaption><\/figure>\n<p>Pulse generator is seen in the left infraclavicular region with three leads connected. One lead is seen free behind the pulse generator, possibly an earlier right ventricular lead which has been abandoned. It may be noted that an abandoned lead is of special interest in consideration of potential magnetic resonance imaging.<sup>1<\/sup> Abandoned pacing leads show resonant heating with greater lead tip heating than leads connected to a pulse generator. The lead with J shaped tip has its tip located in the right atrial appendage for atrial pacing. Right ventricle shows two bipolar leads side by side near the left hemidiaphragm, one being an old abandoned ventricular lead and another an active right ventricular lead. The left ventricular lead going through the coronary sinus to settle in coronary vein with two electrodes at higher inter electrode distance is better seen the picture below. The atrial electrode tip shows a screw suggesting that it is a screw in lead than a tined lead. Ventricular lead tips are suggestive of tined leads with no screw visible.<\/p>\n<figure id=\"attachment_18787\" aria-describedby=\"caption-attachment-18787\" style=\"width: 583px\" class=\"wp-caption alignnone\"><a href=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2015\/01\/crt2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-18787 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2015\/01\/crt2.jpg\" alt=\"Penetrate view of X-ray chest in CRT showing LV, RV and RA leads\" width=\"583\" height=\"584\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2015\/01\/crt2.jpg 583w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2015\/01\/crt2-300x300.jpg 300w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2015\/01\/crt2-150x150.jpg 150w\" sizes=\"auto, (max-width: 583px) 100vw, 583px\" \/><\/a><figcaption id=\"caption-attachment-18787\" class=\"wp-caption-text\">Penetrated view of X-ray chest in CRT showing LV, RV and RA leads<\/figcaption><\/figure>\n<p><span style=\"color: #0000ff;\"><strong>References<\/strong><\/span><\/p>\n<ol>\n<li>Langman DA, Goldberg IB, Finn JP, Ennis DB. Pacemaker lead tip heating in abandoned and pacemaker-attached leads at 1.5 tesla mri. J Magn Reson Imaging 2011, 33:426-31.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Cardiac resynchronization therapy (CRT) is biventricular pacing in which one lead paces the right ventricle endocardially, another the left ventricle epicardially through a coronary vein and a third paces the right atrial appendage. It is a mode of treatment of left ventricular failure due to cardiac dyssynchrony, usually with left bundle branch block and wide QRS complex.<\/p>\n","protected":false},"author":1,"featured_media":18785,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6],"tags":[],"class_list":["post-18784","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Cardiac resynchronization therapy (CRT) - X-ray - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"description\" content=\"Cardiac resynchronization therapy (CRT) is biventricular pacing in which one lead paces the right ventricle endocardialy, another the left ventricle epicardially through a coronary vein and a third paces the right atrial appendage.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/cardiac-resynchronization-therapy-crt-x-ray\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cardiac resynchronization therapy (CRT) - X-ray - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"Cardiac resynchronization therapy (CRT) is biventricular pacing in which one lead paces the right ventricle endocardialy, another the left ventricle epicardially through a coronary vein and a third paces the right atrial appendage.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/cardiac-resynchronization-therapy-crt-x-ray\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2015-01-26T17:32:53+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-10-29T09:37:17+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2015\/01\/crt.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"532\" \/>\n\t<meta property=\"og:image:height\" content=\"450\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/cardiac-resynchronization-therapy-crt-x-ray\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/cardiac-resynchronization-therapy-crt-x-ray\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Cardiac resynchronization therapy (CRT) &#8211; 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