EFFECT OF THE NUMBER OF VENTRICULAR LEADS ON RIGHT-VENTRICULAR HEMODYNAMICS IN PATIENTS WITH PERMANENT PACEMAKER

During pacemaker replacement most of the old leads are not suitable fo r recent needs or may show signs of dysfunction. These leads are diffi cult to extract and are therefore left-in situ. In this study 32 patie nts with one ventricular lead (Group I) were compared echocardiographi cally with 18 patients with two ventricular leads (Group II) in regard to their right ventricular (RV) hemodynamics. Mean age of the patient s in each group was sixty-one years. Patients were evaluated echocardi ographically after two years of lead implantation. Two groups were com pared for right atrial (RA) area, RA and RV diameters, tricuspid insuf ficiency (TI), and intravascular and intracardiac thrombosis. There we re no significant differences between the two groups in terms of RA, a nd RV diameters, RA area, and venous and intracardiac thrombosis. In g roup I, 15 patients with (46.9%) grade I, 14 (43.7%) with grade II, an d 3 (9.4%) with grade III TI were detected. In group II 2 patients (11 .1%) with grade I, 6 (33.3%) with grade II, and 10 (55.6%) with grade III TI were detected. In conclusion, the incidence of TI was more freq uent and of higher degree in group II than in group I, but this findin g was hemodynamically insignificant.