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Abstract Background The temporary pacing lead routinely is placed into right ventricular (RV), which pose a risk of dislocation and cardiac perforation. Objective We aim to evaluate the effectiveness and safety of temporary transvenous cardiac pacing (TTCP) leads placement into the coronary sinus vein (CSV) in patients with sick sinus syndrome (SSS). Methods We investigated patients with SSS who underwent TTCP lead placement into the CSV under the guidance of X‐ray between January 2013 and May 2023. Patients were randomly divided into two groups: RV group (n = 33) and CSV group (n = 22). The ordinary passive bipolar electrodes were applied in both groups. In RV groups, electrodes were placed into RV. In CSV group, electrodes were placed into CSV. We evaluated the operation duration, fluoroscopic exposure, first‐attempt success rate of leads placement, pacing threshold, success rate of leads placement, rate of leads displacement, and complications. Results Compared with that in RV group, the procedure time, fluoroscopic exposure was significantly prolonged, while the first‐attempt success rate of lead placement was obviously increased in CSV group (both p .05). Conclusion TTCP leads placement into the CSV is an effective and safe strategy in patients with SSS. It indicates a high rate of pacing effectiveness with low device replacement and complication rates.

Abstract A 37‐year‐old man was admitted to our hospital with paroxysmal palpitation for half year. A previous electrogram showed a narrow complex tachycardia. Electrophysiologic study (EPS) found a concealed left‐sided free wall pathway accessory. In addition, a transseptal approach was used for radiofrequency ablation. After successful ablation, EPS induced a wide complex tachycardia and a narrow complex tachycardia. The wide complex tachycardia was diagnosed as a right‐sided Mahaim fiber atriofascicular accessory pathway, and the narrow complex tachycardia was diagnosed as atypical atrioventricular nodal reentrant tachycardia (AVNRT). Then, the right‐sided Mahaim fiber atriofascicular accessory pathway and atypical AVNRT were successfully ablated. Herein, we report a rare case of a concealed left‐sided accessory pathway combined with a right atriofascicular Mahaim fiber and atypical AVNRT.

Abstract Background It is difficult to insert cardiac pacing leads in patient with tricuspid valve surgery (TVS). The aim of this study was to evaluate safety and effectiveness of a novel technique applied for bedside temporary pacemaker placement (TPP) in patients with TVS. Methods We investigated patients with TVS who required bedside TPP without X‐ray guidance in cardiac intensive care unit between January 2019 and March 2022. They were divided into Novel pre‐shaped group (N = 21) and Control group (routine pre‐shaped group, N = 26). The ordinary bipolar electrodes were applied in both groups. In Novel pre‐shaped group, electrodes were reshaped by a novel technique with three‐curve with anterior tip method, while electrodes were shaped by traditional strategy in Control group. We evaluated the operation duration, first‐attempt success rate of the lead placement, pacing threshold, success rate of lead placement, the rate of leads displacement, and complications. Results Compared with that in Control group, the procedure time was significantly shortened and the first‐attempt success rate of lead placement was obviously increased in Novel pre‐shaped group (both p

Abstract A 54‐year‐old man had a dual‐chamber pacemaker implantation 9 years ago because of sick sinus syndrome at a different facility. The patient did not undergo any evaluation of his pacemaker for a long time with cardiologist. The patient was admitted to another hospital manifesting dyspnea and palpitation with atrial fibrillation for 1 month, and he was diagnosed with ventricular lead perforation. For further treatment, he was referred to our hospital, and an elective replacement indicator (ERI) of the battery state and a malpositioned ventricular lead into the middle cardiac vein were found. Finally, the pacing lead was left in the primary place and the pacemaker was replaced.