Key result
Transvenous atrial lead implantation via the pulmonary artery enables dual-chamber pacing in total cavopulmonary connection.
Why the study?
Patients after Fontan surgery are prone to bradyarrhythmias, but a transvenous approach to a cardiac chamber is difficult following total cavopulmonary connection with an extracardiac conduit.
Can a transvenous approach via the pulmonary artery be used to establish dual-chamber pacing in a patient with TCPC using an extracardiac conduit?
Case Report (n=1)
Can a transvenous approach via the pulmonary artery be used to establish dual-chamber pacing in a patient with TCPC using an extracardiac conduit?
A transvenous approach to the atrial roof via the pulmonary artery is a feasible option for establishing dual-chamber pacing in patients with TCPC, potentially avoiding high-risk epicardial surgery.
Successful in one TCPC case; leaves open safety, durability, and applicability in larger cohorts.
BACKGROUND: Patients are prone to bradyarrhythmias after Fontan surgery due to anatomical reasons and the surgery, whereas a transvenous approach to a cardiac chamber is difficult in patients after total cavopulmonary artery connection (TCPC) with an extracardiac conduit. METHODS AND RESULTS: We report a case of transvenous implantation of an atrial lead into the atrial roof via the pulmonary artery and a successful upgrade to the dual chamber pacing using an existing epicardial ventricular lead. CONCLUSION: A transvenous approach toward atrial roof via pulmonary artery may be a possible option in patients with TCPC. If successful, high-risk additional surgery can be avoided.
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Nagayama et al. (2025) conducted a case report in Bradyarrhythmias after Fontan surgery with total cavopulmonary artery connection (TCPC) (n=1). Transvenous implantation of an atrial lead into the atrial roof via the pulmonary artery was evaluated on Successful upgrade to dual chamber pacing. Transvenous implantation of an atrial lead into the atrial roof via the pulmonary artery successfully enabled dual-chamber pacing in a patient with total cavopulmonary connection.
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