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The insertion of electrodes into the ventricles is done under local anesthetic, with access to the ventricles most commonly via the subclavian vein, although access may be conferred from the axillary or cephalic veins. Right ventricular access is direct, while left ventricular access is conferred via the coronary sinus (CS).
Right ventricular outflow tract tachycardia originates from the outflow tract of the right ventricle or the tricuspid annulus. As it arises from the right ventricle, the impulse spreads inferiorly from beneath the pulmonary valve, and there right axis deviation.
An important potential finding with echo is McConnell's sign, where only the RV apex wall contracts; [7] it is specific for right heart strain and typically indicates a large PE. [8] On an electrocardiogram (ECG), there are multiple ways RV strain can be demonstrated. A finding of S1Q3T3 [b] is an insensitive [10] sign of right heart strain. [11]
A right bundle branch block typically causes prolongation of the last part of the QRS complex and may shift the heart's electrical axis slightly to the right. The ECG will show a terminal R wave in lead V1 and a slurred S wave in lead I. Left bundle branch block widens the entire QRS, and in most cases shifts the heart's electrical axis to the ...
The Trendelenburg position can be used to treat a venous air embolism by placing the right ventricular outflow tract inferior to the right ventricular cavity, causing the air to migrate superiorly into a position within the right ventricle from which air is less likely to embolise. [4]
The type of VAD implanted depends on the type of underlying heart disease (e.g. patients with right ventricular failure from pulmonary arterial hypertension may require an RVAD, versus those with left ventricular failure from a myocardial infarction may require an LVAD). The LVAD is the most common device applied to a defective heart (it is ...
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Tears or ruptures of the right ventricular outflow tract may occur during the procedure, especially if the tract is already heavily calcified. [4] This is reported to occur in up to 9% of procedures. [4] Most cases are manageable by using a covered stent and do not lead to severe bleeding. [4] Infective endocarditis occurs at a rate of about 1% ...
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