Why the study?
In Fontan patients needing pacing, novel options are needed to avoid leaded systems, epicardial pacing, or multiple thoracotomies when other options are exhausted or to avoid surgery.
Does leadless pacemaker implantation via trans-carotid and trans-fenestration approaches provide a feasible pacing option in the extra-cardiac Fontan cohort?
Does leadless pacemaker implantation via trans-carotid and trans-fenestration approaches provide a feasible pacing option in the extra-cardiac Fontan cohort?
Trans-carotid and trans-fenestration leadless pacemaker implantation offers a feasible, less invasive pacing alternative to epicardial systems for Fontan patients.
Answers are grounded in this paper and cite their sources.
May offer less invasive pacing in Fontan patients; hypothesis-generating and should not yet change practice.
Leadless pacemaker implantation via trans-carotid and trans-fenestration approaches appears to be a feasible back up option for pacing in Fontan patients where other options have been exhausted or there is a patient choice to avoid surgery. These techniques provide an option to avoid leaded systems or epicardial pacing, reducing the need for multiple thoracotomies and addressing challenges associated with surgical pacing leads. Further studies are needed to evaluate long-term outcomes and assess the broader application of leadless pacemakers in the Fontan population.
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Goulden et al. (2023) studied this question.
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