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Development of a new lead for in utero fetal pacing
Author(s) -
Boudjemline Younes,
Rosenblatt Jonathan,
de La Villeon Grégoire,
Bénifla JeanLouis,
Bonnet Damien,
Jouannic JeanMarie
Publication year - 2010
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2422
Subject(s) - lead (geology) , medicine , cardiology , geology , geomorphology
Background The results from preliminary studies on fetal pacing preclude an application to the human fetus. The purpose of this study was to evaluate the feasibility of acute fetal cardiac pacing following ultrasound‐guided epicardial anchorage of a new pacing lead dedicated to the fetal heart. Methods In 12 pregnant ewes, a needle was placed in contact with cardiac chambers under echo‐guidance. Using the lumen of the needle, a 3‐Fr pacing lead was advanced and fixed on the cardiac wall using a built‐in screw. Pacing was attempted using an external pacing system. Results Lead insertion was successful in all but one. In the first fetus, the needle was advanced too far into the right ventricle leading to pericardial bleeding. The fetal heart rate was overdriven in all at 220/ min. After assessment, pacing lead was unscrewed and retrieved without any complication. Pregnancy was electively interrupted in six animals. The other six fetuses were delivered vaginally after uneventful pregnancy and autopsy at day 3 did not show any significant injury. Conclusions Transcutaneous echo‐guided fetal acute pacing is feasible using a specially designed lead. Additional refinement of both the equipments and the operative technique are needed before considering permanent pacing in the human fetus. Copyright © 2009 John Wiley & Sons, Ltd.