Ploux et al reported an algorithm that can help to determine the left ventricular position for the lead of a cardiac resynchronization device. The authors are from the University Victor Degalen and Hospital Haut Leveque in France.
Patient selection: cardiac resynchronization device with a lead in the left ventricle
If there is an R wave in lead V1, then the lead is on the free wall.
If there is no R wave in lead V1, then the lead is interventricular.
R wave in V1
Other
Location
present
predominantly positive QRS complex in V2
posterior
present
predominantly negative QRS complex in V2, not R wave only in aVL
lateral
present
predominantly negative QRS complex in V2, R wave only in aVL
inferior
absent
rS, predominantly negative QRS complex in V6
inferior
absent
rS, predominantly positive QRS complex in V6
anterior
absent
QS pattern in anterior leads
anterior
where:
• An inferior location was never associated with a positive QRS in V6 (page S4).
• aVL is mostly negative when the lateral left ventricular wall is stimulated.
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