Permanent Pacing from the Coronary Sinus in a Patient with an Implantable Defibrillator

A woman with an ICD underwent permanent pacemaker implantation for bradycordia-tachycardia syndrome. Despite multiple right atrial positions, oversensing secondary to "double counting" was always noted. A coronary sinus pacing catheter was inserted and left atrial pacing was accomplished with acceptable pacing and sensing characteristics. The patient has since done well without further shocks.