{"id":23588,"date":"2018-02-28T21:09:45","date_gmt":"2018-02-28T15:39:45","guid":{"rendered":"https:\/\/cardiophile.org\/?p=23588"},"modified":"2022-11-26T05:06:42","modified_gmt":"2022-11-25T23:36:42","slug":"septal-pacing-x-ray-chest-pa-view","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/septal-pacing-x-ray-chest-pa-view\/","title":{"rendered":"Septal pacing &#8211; X-ray chest PA view"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/WZEu6URl7R4\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Septal pacing &#8211; X-ray chest PA view<\/span><\/h2>\n<figure id=\"attachment_23589\" aria-describedby=\"caption-attachment-23589\" style=\"width: 561px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-23589 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2018\/02\/septal-pacing.png\" alt=\"Septal pacing - X-ray chest PA view\" width=\"561\" height=\"426\"><figcaption id=\"caption-attachment-23589\" class=\"wp-caption-text\"><span style=\"color: #0000ff;\"><strong><em>Septal pacing lead seen on X-ray chest PA view<\/em><\/strong><\/span><\/figcaption><\/figure>\n<p>Pacemaker pulse generator is seen in the left infraclavicular region and the lead can be seen emanating from it. The lead is usually inserted through a left subclavian or axillary vein puncture using percutaneous technique. Under fluoroscopic guidance the lead tip is positioned in the right ventricle.<\/p>\n<p>Earlier most of the lead tips were positioned at the apex of right ventricle. Though this position is easier to achieve, long term adverse effect of right ventricular apical pacing can occur due to dyssynchrony of left ventricular contraction. Apical pacing usually has a left bundle branch block pattern. If septal pacing can be done using screw in leads as in this case, it is possible that it can capture the conduction system more proximally so that the dyssynchrony may be lesser. This has the advantage of better long term left ventricular function.<\/p>\n<p>In terms of left ventricular function and width of the QRS, pacing the septal aspect of right ventricular outflow tract is another good option [1].<\/p>\n<p><strong><span style=\"color: #0000ff;\">Reference<\/span><\/strong><\/p>\n<ol>\n<li>Francis J, Jayesh B, Ashishkumar M, Faizal A, Mond H. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2811205\/\">Right ventricular septal pacing: has it come of age?<\/a> Indian Pacing Electrophysiol J. 2010 Feb 1;10(2):69-72.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Septal pacing &#8211; X-ray chest PA view: Pulse generator is seen in the left infraclavicular region and the lead can be seen emanating from it. If septal pacing can be done using screw in leads as in this case, it is possible that it can capture the conduction system more proximally so that the dyssynchrony may be lesser.<\/p>\n","protected":false},"author":1,"featured_media":23589,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[4],"tags":[],"class_list":["post-23588","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiology-x-ray"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Septal pacing - X-ray chest PA view - Lead tip in mid septum<\/title>\n<meta name=\"description\" content=\"Septal pacing - X-ray chest PA view: Pulse generator is seen in the left infraclavicular region and the lead can be seen at the location of mid septum.\" \/>\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\/septal-pacing-x-ray-chest-pa-view\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Septal pacing - X-ray chest PA view - Lead tip in mid septum\" \/>\n<meta property=\"og:description\" content=\"Septal pacing - X-ray chest PA view: Pulse generator is seen in the left infraclavicular region and the lead can be seen at the location of mid septum.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/septal-pacing-x-ray-chest-pa-view\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2018-02-28T15:39:45+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-11-25T23:36:42+00:00\" \/>\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=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/septal-pacing-x-ray-chest-pa-view\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/septal-pacing-x-ray-chest-pa-view\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Septal pacing &#8211; 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