Permanent ventricular pacing via a low posterolateral cardiac vein in a patient with a mechanical tricuspid valve prosthesis and complete atrioventricular block

In the presence of an artificial tricuspid valve, permanent pacing is generally achieved with an epimyocardial approach. This report describes the implantation of a dedicated pacing electrode in a low posterolateral cardiac vein in a patient with a mechanical prosthetic tricuspid, mitral and aortic valve in whom an epimyocardial lead and pacemaker generator had to be removed because of infection.