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Ann Thorac Surg 1999;67:958
© 1999 The Society of Thoracic Surgeons

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Commentary

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Invited commentary

Unconventional approaches associated with treating pacemaker and implantable cardiac defibrillator implants are becoming more prevalent because of the increased incidence of device-related complications. This is especially true for younger patients with or without congenital heart disease. Complications range from life-threatening infections, forcing removal and reimplantation of devices, to an inability to insert transvenous pacing leads using conventional procedures. The latter is the subject of the present study.

The techniques presented are improvisations of routine coronary sinus and transatrial implant procedures. The insertion of leads through a transatrial approach is essential in my practice. My recent experiences in more than 100 cases have been both successful and uneventful. It is used in situations where the superior . . . [Full Text of this Article]

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Unconventional approaches to cardiac pacing in patients with inaccessible cardiac chambers

Daniel J. Goldstein, David Rabkin, and Henry M. Spotnitz
Ann. Thorac. Surg. 1999 67: 952-958. [Abstract] [Full Text] [PDF]