Difference between revisions of "X-ray of cardiac pacemakers"

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[[File:X-ray of pacemaker with right atrial and ventricular lead.jpg|thumb|350px|Single-chamber pacemaker with right normally located atrial and ventricular leads.]]
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|author1=[[User:Mikael Häggström|Mikael Häggström]]
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[[File:X-ray of pacemaker with right atrial and ventricular lead.jpg|thumb|350px|Pacemaker with normally located leads in the right atrium (white arrow) and right ventricle (black arrowhead), respectively.]]
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==Planning==
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[[X-ray of the chest]] is often (but not always) done routinely the day after pacemaker insertion, both to check the positions of the electrodes as well as to exclude the complication of pneumothorax (see [[X-ray of pneumothorax]]).<ref name="pmid25815303">{{cite journal| author=Kotsakou M, Kioumis I, Lazaridis G, Pitsiou G, Lampaki S, Papaiwannou A et al.| title=Pacemaker insertion. | journal=Ann Transl Med | year= 2015 | volume= 3 | issue= 3 | pages= 42 | pmid=25815303 | doi=10.3978/j.issn.2305-5839.2015.02.06 | pmc=4356861 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25815303}}</ref>
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==Evaluation==
 
;Atrial lead
 
;Atrial lead
 
For right atrial and right ventricular leads for single-chamber and dual-chamber pacemakers, the right atrial lead should demonstrate a "J-shaped" on lateral view, appearance since it curves upward and anteriorly in the right atrial appendage.<ref name="AguileraVolokhina2011">{{cite journal|last1=Aguilera|first1=Amanda L.|last2=Volokhina|first2=Yulia V.|last3=Fisher|first3=Kendra L.|title=Radiography of Cardiac Conduction Devices: A Comprehensive Review|journal=RadioGraphics|volume=31|issue=6|year=2011|pages=1669–1682|issn=0271-5333|doi=10.1148/rg.316115529}}</ref>
 
For right atrial and right ventricular leads for single-chamber and dual-chamber pacemakers, the right atrial lead should demonstrate a "J-shaped" on lateral view, appearance since it curves upward and anteriorly in the right atrial appendage.<ref name="AguileraVolokhina2011">{{cite journal|last1=Aguilera|first1=Amanda L.|last2=Volokhina|first2=Yulia V.|last3=Fisher|first3=Kendra L.|title=Radiography of Cardiac Conduction Devices: A Comprehensive Review|journal=RadioGraphics|volume=31|issue=6|year=2011|pages=1669–1682|issn=0271-5333|doi=10.1148/rg.316115529}}</ref>
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The tip of the right ventricular lead should be to the left of the spine on frontal view. In lateral view, it should course anteriorly into the apex of the right ventricle.<ref name="AguileraVolokhina2011"/>
 
The tip of the right ventricular lead should be to the left of the spine on frontal view. In lateral view, it should course anteriorly into the apex of the right ventricle.<ref name="AguileraVolokhina2011"/>
  
==References==
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==Reporting==
{{reflist}}
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In every X-ray where a pacemaker is present, it is apt to describe the corresponding atrium or ventricle of the electrode location, and acceptable to not comment the positioning of the electrode tip unless it is misaligned, or specifically requested in the referral.
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Latest revision as of 17:53, 26 October 2018

Author: Mikael Häggström [notes 1]

Pacemaker with normally located leads in the right atrium (white arrow) and right ventricle (black arrowhead), respectively.

Planning

X-ray of the chest is often (but not always) done routinely the day after pacemaker insertion, both to check the positions of the electrodes as well as to exclude the complication of pneumothorax (see X-ray of pneumothorax).[1]

Evaluation

Atrial lead

For right atrial and right ventricular leads for single-chamber and dual-chamber pacemakers, the right atrial lead should demonstrate a "J-shaped" on lateral view, appearance since it curves upward and anteriorly in the right atrial appendage.[2]

Right ventricular lead

The tip of the right ventricular lead should be to the left of the spine on frontal view. In lateral view, it should course anteriorly into the apex of the right ventricle.[2]

Reporting

In every X-ray where a pacemaker is present, it is apt to describe the corresponding atrium or ventricle of the electrode location, and acceptable to not comment the positioning of the electrode tip unless it is misaligned, or specifically requested in the referral.

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. Kotsakou M, Kioumis I, Lazaridis G, Pitsiou G, Lampaki S, Papaiwannou A et al. (2015). "Pacemaker insertion. ". Ann Transl Med 3 (3): 42. doi:10.3978/j.issn.2305-5839.2015.02.06. PMID 25815303. PMC: 4356861. Archived from the original. . 
  2. 2.0 2.1 Aguilera, Amanda L.; Volokhina, Yulia V.; Fisher, Kendra L. (2011). "Radiography of Cardiac Conduction Devices: A Comprehensive Review ". RadioGraphics 31 (6): 1669–1682. doi:10.1148/rg.316115529. ISSN 0271-5333.