epicardial lead
A pacemaker or ICD lead surgically placed directly on the outer surface of the heart muscle.
Full Definition
Epicardial leads are cardiac device electrodes positioned on the epicardial surface of the heart through surgical thoracotomy or thoracoscopic procedures, as opposed to transvenous leads passed through blood vessels. These leads are typically reserved for patients with contraindications to transvenous access, such as prosthetic tricuspid valves, intracardiac shunts, venous occlusion, or high infection risk. Epicardial placement is also common in pediatric patients due to size constraints and growth considerations. While epicardial leads avoid vascular complications, they may have higher capture thresholds, shorter longevity, and require surgical expertise for implantation and revision. Lead performance monitoring is crucial due to potential insulation degradation and exit block.
Usage
Usage note: Distinguish clearly from endocardial/transvenous leads; specify surgical approach when relevant.
In Context
- "Epicardial lead implantation was performed due to tricuspid valve prosthesis precluding transvenous access." — Cardiac surgery procedure note
- "The epicardial ICD lead demonstrated stable thresholds and impedances at six-month follow-up." — Pediatric device clinic report