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Heart Disease (Expert Forum)
Left and right sided?
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Left and right sided?
by Mickie, Sep 10, 2001 12:00AM
Thank-you for taking the time to answer so many people's questions. I have posted 2 questions here before, the last one was under the topic "Pacemaker" and the Suject "Epicardial lead." My medical history is in that post, but I don't think it is really relevant to my question(except, maybe, that my pacer goes in to noise reversion when I touch things that really shouldn't put it in this mode, like my shower, stove, fridge...nobody an seem to figure this out). My question is about the side of the body that pacemakers go on. I have noticed that pacemaker companies make "right-sided" and "left-sided" pacemakers. So that makes me think that there must be some reason that the pacer is suppossed to be on that side of the body. Does it actually matter which side of the body a certian model of pacemaker is implanted on? If it does matter, and it is on the wrong side, what sort of problems could this cause? I ask this becuase I have a Pacesetter Trilogy DR+ 2364L. The technical manual says that it is "intended for implantation on the right side of the body", and it is in my left abdomen(unipolar, epicardial leads). If my doctors wanted it on the left, why wouldn't they just put in the Trilogy DR+ 2360L? I have one more question. Could you please tell me about the subxiphoid approach to replacing epicardial leads? The leads I have now where put in by sternotomy during an emergency SVC repair. My doctor mentioned this approach to me the last time I saw him, but didn't really explain it. Thank-you again for you time. Have a nice day. *Mickie*
Doctor's Answer
by CCF-M.D.-CRC, Sep 11, 2001 12:00AM
Dear Mickie,
The left and right designations have to do with the direction that the leads plug into the generator. The optimal configuration is thought to be to have the leads pluged (plugged) in so they are facing towards the heart. This is to reduce the mechanical stress on the leads. This is why some pacemakers are right and some are left. They are mirror images of each other. Some pacemakers can be turned over on either side so that the same device can be used on the right or the left. All that being said it does not really matter which side the pacemaker is placed, especially in the abdomen. There is much less mechanical stress on the lead in the abdomen and either model can be used.
A subxiphoid approach refers to a surgical technique to open heart surgery where the incision is made just below the rib cage instead of through the breastbone. In general this is a less invasive technique and is often used for epicardial pacemaker leads.
The left and right designations have to do with the direction that the leads plug into the generator. The optimal configuration is thought to be to have the leads pluged (plugged) in so they are facing towards the heart. This is to reduce the mechanical stress on the leads. This is why some pacemakers are right and some are left. They are mirror images of each other. Some pacemakers can be turned over on either side so that the same device can be used on the right or the left. All that being said it does not really matter which side the pacemaker is placed, especially in the abdomen. There is much less mechanical stress on the lead in the abdomen and either model can be used.
A subxiphoid approach refers to a surgical technique to open heart surgery where the incision is made just below the rib cage instead of through the breastbone. In general this is a less invasive technique and is often used for epicardial pacemaker leads.
