96-36: Sheath-guided Permanent Pacemaker Lead Delivery to Right Ventricular Septum: A Newly Developed Long-type Peel Off Sheath

Abstract

Purpose: The aim of this study was to evaluate the feasibility and reliability of sheath-guided RV septal lead delivery technique without depending on pre or self-shaped stylet support. Methods: A newly developed 7F multipurpose long type peel off sheath with curve shape was used(Fig. 1). We inspected whether conventional active fixation leads available in Japan could pass this sheath smoothly in vitro. Thereafter, we performed pacemaker implantation for 20 patients with sheath-guided lead delivery technique. Guide Sheath was advanced into right ventricle and active fixation lead was delivered through the sheath. Results: Table 1 shows the data of active fixation leads available with this guide sheath in vitro and in vivo. Even if 6F lead, whose apical housing part was relatively hard and long, could not advance the curve part of the sheath. In other available leads, use of guiding sheath greatly facilitated rapid, stable and safety lead delivery to the right ventricular septum. Because an active fixation lead could not affect a vein and a tricuspid valve, the delivery by the guide sheath was more safety. No adverse events were reported. Conclusion: Sheath-guided lead delivery is promising technique for RV septal pacing. Active fixation leads available with multipurpose peel off guide sheath Active fixation leads available with multipurpose peel off guide sheath