Estimulación septal del ventrículo derecho como alternativa a la estimulación apical. ¿Cómo ubicar el electrodo?

Marleny Cruz Cardentey, Zana A Cort, Alain Gutierrez Lopez, Ana Mengana Betancourt, Michel Yoet Ramos Cordero

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Resumen

Los efectos perjudiciales de la estimulación apical del ventrículo derecho se conocen desde hace décadas y están en relación con el porcentaje de estimulación ventricular. El septum ventricular derecho es el sitio alternativo a la estimulación apical más estudiado. A pesar de su teórica superioridad, la evidencia médica ha sido heterogénea y no ha demostrado su claro beneficio. Convencionalmente, la posición septal del electrodo se confirma por la proyección fluoroscópica de la sonda y por las características electrocardiográficas, pero varios estudios han demostrado sus limitaciones. Aunque el empleo combinado de múltiples vistas fluoroscópicas nos permiten asegurar una ubicación septal con alta precisión, este enfoque necesita de grandes estudios prospectivos, que empleen a la tomografía cardiaca contratada como método de validación.

Palabras clave

marcapasos cardiaco, estimulación septal del ventrículo derecho.

Referencias

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