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Eur J Cardiothorac Surg 2004;25:894-896
© 2004 Elsevier Science NL

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Minimal invasive epicardial lead implantation: optimizing cardiac resynchronization with a new mapping device for epicardial lead placement

^a Department of Cardio Thoracic Surgery, Cardiovascular Research Institute Maastricht, University Hospital Maastricht, Maastricht, The Netherlands
^b Department of Cardiology, Cardiovascular Research Institute Maastricht, University Hospital Maastricht, Maastricht, The Netherlands

Received 20 October 2003; received in revised form 26 January 2004; accepted 29 January 2004.

^* Corresponding author. Tel.: +31-43-387-5070; fax: +31-43-387-5075
e-mail: j.maessen{at}scpc.azm.nl

To optimize resynchronization in biventricular pacing with epicardial leads, mapping to determine the best pacing site, is a prerequisite. A port access surgical mapping technique was developed that allowed multiple pace site selection and reproducible lead evaluation and implantation. Pressure–volume loops analysis was used for real time guidance in targeting epicardial lead placement. Even the smallest changes in lead position revealed significantly different functional results. Optimizing the pacing site with this technique allowed functional improvement up to 40% versus random pace site selection.

Key Words: Minimal invasive • Resynchronization • Biventricular pacing • Pressure–volume loops

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