X-Ray Flashcards
Which view (LOA or RAO) shows the CS take off angles and bifurcations?
RAO
Which view (LOA or RAO) shows RV lead apex to basal separation?
RAO
Which view (LOA or RAO) is the best to show RV and LV lead slack?
LAO
Which view (LOA or RAO) is the best lead to see the distance between the RV and LV leads?
LAO
What does RAO and LAO stand for?
- RAO = Right Anterior Oblique
- LAO = Left Anterior Oblique
What x-ray view are you looking at If a “Frog Face” is seen on the image?
AP or antero-posterior view
What are clues that an AP x-ray was taken?
- “frog face” seen or the fascicles (eyes) and vertebral body
- sternum or sternal sutures are directly over the spine
- equal right and left rib length
What are clues that an RAO x-ray was taken?
- RV lead elongation will be seen
- spine or spinal processes on the left side of the image
- sternal wires on the right side of the image
- tarantula sign (sternum with ribs coming off)
In what x-ray view will the spine or spinal processes be on the left side of the image?
RAO
In what x-ray view will the sternal wires be on the right side of the image?
RAO
In what x-ray view will RV lead elongation be seen?
RAO
What is the best x-ray view to verify apical RV lead placement?
RAO
What are clues that an LAO x-ray was taken?
- spine/spinal processes on the right side of the image
- spine runs down the middle of the heart
- sternal wires on the left side of the image
- rounded left cardiac silhouette border
In what x-ray view will RV lead foreshortening be seen?
LAO
What is the position of the LV if it is pointing towards the patients left in an LAO image?
lead is anterior and needs to be move
What is the ideal placement of the LV lead viewing an LAO image?
lead is pointing towards the patients right and is in between the 2 and 5 o’clock position
Which view is used to see if the RV lead is in apically placed?
RAO
Which lead is best to see if the RV lead is septal in placement?
LAO
Where is the RV lead placed if it pointing up and away from the spine in an LAO image?
lead is in the RV free wall and needs to be repositioned
How can you tell if the RA is in the RAA while viewing an LAO image?
- the tip of the lead will be parallel to the rest of the lead
- pointed up and will see “windshield wiper” motion under live fluoroscopy
Where is the RA lead positioned if the tip of the lead is pointing medially or towards the spine in LAO view?
- lead is in the atrial septum
- lead appears to have a more “J” curved shape
Where is the RA lead positioned if the tip of the lead points superiorly or appears parallel to the body of the lead when viewing in the LAO view?
- lead is in the Right Atrial Appendage (RAA)
- lead appears to have tight “J” shaped curve
Where is the RA lead positioned if the tip is pointed away from the spine while viewing in the AP view?
lead is on the lateral wall
Why is the lateral wall a bad position for atrial lead placment?
- wall is thin and phrenic nerve runs along the right and left lateral walls of the heart
