Leads

Before I further quiz my EP.......................what is the typical setup of a three lead PM?  What is the third lead used for (mine has stopped working). PM - with the 3 leads was implanted in 2012.  It has since been replaced with a Medtronic PM/ICD.  Just trying to shore up my knowledge base.


2 Comments

Three leads

by AgentX86 - 2020-02-18 00:48:59

A three-lead PM is known as a CRT-P (if it's a pacemaker) or CRT-D (if also a defibrillator). The first two leads are essentially the same as a two lead PM - one lead in the right atrium and one in the right ventricle. This sort of pacemaker is used to correct AV block. It basically replaces the AV node and Bundle of His, "connecting" the right atrium and right ventricle.

A CRT (Cardiac Resyncronization Therapy) pacemaker adds the third lead to the left ventricle so the left and right ventricles can beat together. Right-ventrical only pacing can cause enlargement of the heart because the left and right ventricles don't support each other during the beginning of the contraction. One ventricle fights the other. CRT pacing corrects this, if it's a problem.

what AgentX86 said

by dwelch - 2020-02-18 11:20:36

you might hear the term biventrical from the EP or others one atrial and two ventrical left and right so that they can independently control the ventricles so that they can have them hit at the same/right time.  I just switched from a 2 lead to biventrical (three lead)(for av block).

 

 

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