Lead Position Evaluation in Patients with Implanted Devices

Patients with CRT have an epicardial lead for LV and two endocardial leads, one in the right ventricle and one in the right atrium. Patients with dual chamber pacemakers have an electrode in the right ventricle and another in the right atrium. Patients with a single-chamber pacemaker present a lead at the level of the right ventricle. Patients with ICD with or without pacemaker represent another category. Echocardiography is essential for right ventricle lead position identification, especially before a planned upgrade. In CRT patients, the lead must be implanted far from the fibrosis area and will be evaluated in non-responders. The right atrial lead position usually necessitates transesophageal echocardiography.