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Permanent Transvenous Left Ventricular Endocardial Pacing in a Patient with Univentricular Atrioventricular Connection
Authors:Paul A. Scott MBChB  Gruschen R. Veldtman MD  Arthur M. Yue DM  John M. Morgan MD
Affiliation:1. Wessex Cardiothoracic Unit, Southampton University Hospital, Southampton, UK;2. University of Southampton, Southampton, UK;3. Congenital Cardiac Unit, Southampton University Hospital NHS Trust, Southampton, UK
Abstract:Chronotropic incompetence is associated with poorer effort tolerance and worse mortality outcomes, not only in the general cardiac population but also in patients with congenital heart disease. When present in complex patients, pacing options may be limited by difficult pacing access, and an open surgical approach for epicardial lead placement may not always be desirable. We describe a case of symptomatic chronotropic incompetence in a patient with tricuspid atresia, valvar and subpulmonary stenosis, normally related great vessels, and a modified Blalock–Taussig shunt, awaiting cardiac transplantation, whom we palliated with a transvenous endocardial pacing strategy. This technique may provide an alternative pacing strategy for highly selected patients, where few other treatment options are available.
Keywords:Pacing  Pacemaker  Chronotropic Incompetence  Univentricular Heart  Congenital Heart Disease
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