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.
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March 2011
Research Papers
Simulation of LV Pacemaker Lead in Marginal Vein: Potential Risk Factors for Acute Dislodgement
Xuefeng Zhao,
Xuefeng Zhao
Department of Biomedical Engineering,
Indiana University Purdue University Indianapolis
, Indianapolis, IN 46202
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Mike Burger,
Mike Burger
Livermore Software Technology Corporation
, Livermore, CA 94550
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Yi Liu,
Yi Liu
Department of Biomedical Engineering,
Indiana University Purdue University Indianapolis
, Indianapolis, IN 46202
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Mithilesh K. Das,
Mithilesh K. Das
Krannert Institute of Cardiology, Roudebush VA Medical Center,
Indiana University School of Medicine
, Indianapolis, IN 46202
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William Combs,
William Combs
Department of Biomedical Engineering,
Indiana University Purdue University Indianapolis
, Indianapolis, IN 46202
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Jonathan F. Wenk,
Jonathan F. Wenk
Department of Surgery and San Francisco VA Medical Center,
University of California at San Francisco
, San Francisco, CA 94121
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Julius M. Guccione,
Julius M. Guccione
Department of Surgery and San Francisco VA Medical Center,
University of California at San Francisco
, San Francisco, CA 94121
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Ghassan S. Kassab
Ghassan S. Kassab
Department of Surgery, and Department of Cellular and Integrative Physiology, Department of Biomedical Engineering,
e-mail: gkassab@iupui.edu
Indiana University Purdue University Indianapolis
, Indianapolis, IN 46202
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Xuefeng Zhao
Department of Biomedical Engineering,
Indiana University Purdue University Indianapolis
, Indianapolis, IN 46202
Mike Burger
Livermore Software Technology Corporation
, Livermore, CA 94550
Yi Liu
Department of Biomedical Engineering,
Indiana University Purdue University Indianapolis
, Indianapolis, IN 46202
Mithilesh K. Das
Krannert Institute of Cardiology, Roudebush VA Medical Center,
Indiana University School of Medicine
, Indianapolis, IN 46202
William Combs
Department of Biomedical Engineering,
Indiana University Purdue University Indianapolis
, Indianapolis, IN 46202
Jonathan F. Wenk
Department of Surgery and San Francisco VA Medical Center,
University of California at San Francisco
, San Francisco, CA 94121
Julius M. Guccione
Department of Surgery and San Francisco VA Medical Center,
University of California at San Francisco
, San Francisco, CA 94121
Ghassan S. Kassab
Department of Surgery, and Department of Cellular and Integrative Physiology, Department of Biomedical Engineering,
Indiana University Purdue University Indianapolis
, Indianapolis, IN 46202e-mail: gkassab@iupui.edu
J Biomech Eng. Mar 2011, 133(3): 031006 (7 pages)
Published Online: February 7, 2011
Article history
Received:
August 9, 2010
Revised:
November 18, 2010
Posted:
December 22, 2010
Published:
February 7, 2011
Online:
February 7, 2011
Citation
Zhao, X., Burger, M., Liu, Y., Das, M. K., Combs, W., Wenk, J. F., Guccione, J. M., and Kassab, G. S. (February 7, 2011). "Simulation of LV Pacemaker Lead in Marginal Vein: Potential Risk Factors for Acute Dislodgement." ASME. J Biomech Eng. March 2011; 133(3): 031006. https://doi.org/10.1115/1.4003323
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