Simulation of LV pacemaker lead in marginal vein: potential risk factors for acute dislodgement.

Xuefeng Zhao, Mike Burger, Y. Liu, Mithilesh K. Das, William Combs, Jonathan F. Wenk, Julius M. Guccione, Ghassan S. Kassab

Research output: Contribution to journalArticle

Abstract

Although left ventricular (LV) coronary sinus lead dislodgement remains a problem, the risk factors for dislodgement have not been clearly defined. In order to identify potential risk factors for acute lead dislodgement, we conducted dynamic finite element simulations of pacemaker lead dislodgement in marginal LV vein. We considered factors such as mismatch in lead and vein diameters, velocity of myocardial motion, branch angle between the insertion vein and the coronary sinus, degree of slack, and depth of insertion. The results show that large lead-to-vein diameter mismatch, rapid myocardial motion, and superficial insertion are potential risk factors for lead dislodgement. In addition, the degree of slack presents either a positive or negative effect on dislodgement risk depending on the branch angle. The prevention of acute lead dislodgment can be enforced by inducing as much static friction force as possible at the lead-vein interface, while reducing the external force. If the latter exceeds the former, dislodgement will occur. The present findings underscore the major risk factors for lead dislodgment, which may improve implantation criterion and future lead design.

Original languageEnglish (US)
Pages (from-to)31006
Number of pages1
JournalJournal of Biomechanical Engineering
Volume133
Issue number3
StatePublished - Mar 2011
Externally publishedYes

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Pacemakers
Veins
Lead
Coronary Sinus
Friction

ASJC Scopus subject areas

  • Biomedical Engineering
  • Physiology (medical)

Cite this

Zhao, X., Burger, M., Liu, Y., Das, M. K., Combs, W., Wenk, J. F., ... Kassab, G. S. (2011). Simulation of LV pacemaker lead in marginal vein: potential risk factors for acute dislodgement. Journal of Biomechanical Engineering, 133(3), 31006.

Simulation of LV pacemaker lead in marginal vein : potential risk factors for acute dislodgement. / Zhao, Xuefeng; Burger, Mike; Liu, Y.; Das, Mithilesh K.; Combs, William; Wenk, Jonathan F.; Guccione, Julius M.; Kassab, Ghassan S.

In: Journal of Biomechanical Engineering, Vol. 133, No. 3, 03.2011, p. 31006.

Research output: Contribution to journalArticle

Zhao, X, Burger, M, Liu, Y, Das, MK, Combs, W, Wenk, JF, Guccione, JM & Kassab, GS 2011, 'Simulation of LV pacemaker lead in marginal vein: potential risk factors for acute dislodgement.', Journal of Biomechanical Engineering, vol. 133, no. 3, pp. 31006.
Zhao, Xuefeng ; Burger, Mike ; Liu, Y. ; Das, Mithilesh K. ; Combs, William ; Wenk, Jonathan F. ; Guccione, Julius M. ; Kassab, Ghassan S. / Simulation of LV pacemaker lead in marginal vein : potential risk factors for acute dislodgement. In: Journal of Biomechanical Engineering. 2011 ; Vol. 133, No. 3. pp. 31006.
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