Anatomic, Histologic and Mechanical Features of the Right Atrium: Implications for Leadless Atrial Pacemaker Implantation.
Matthew O'ConnorUmberto BarberoDaniel B KramerAngela LeeAlina HuaTevfik F IsmailKaren P McCarthySteven A NiedererChristopher Aldo RinaldiVias MarkidesJohn-Ross David ClarkeSonya Babu-NarayanSiew Yen HoRui ShiPublished in: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology (2023)
Based on anatomical review and 3D modelling the best compromise for an atrial LP implantation may be the RAA base (low incidence of collision, relatively thick myocardial tissue and without proximity to relevant epicardial structures); the anteromedial recess of the RAA apex and lateral wall are alternate sites. The mid-RAA, RA/SVC junction and septum appear to be sub-optimal fixation locations.