Pacemaker implantation in a patient with noncompaction and aneurysm of right ventricular combination with postclosure of atrial septal defect

To the editor:Noncompaction of the ventricular myocardium (NVM) can be an isolated condition or co-existed with other congenital cardiac malformations.We report a NVM patient presenting with localized right ventricular aneurysm (VA) formation,atrial septal defect (ASD),and bradycardia,and describe a new tactics by which a dual-chamber pacemaker (PM) was implanted successfully. A 37-year-old male with palpitation and lightheadedness was referred to our hospital for further diagnostic procedures.Two years ago,transthoracic echoeardiography showed dilated ventricle and right atrium (RA),globally hypokinetic left ventricle (LV),thinning hypokinetic myocardium in the apex and outflow tract of right ventricle (RV) and formation of local VA,prominent trabecularization in the lateral wall of right ventricle,and ASD with the diameter of about 10 mm.Deep intertrabecular recesses with flow coming out from RV cavity by color Doppler flow imaging.