Why the study?
Palliated single ventricle patients frequently require epicardial pacemaker implantation, but repeated device hardware replacement due to high lead thresholds or failure is challenging.
3D-printed models can guide novel transmural approaches for endocardial pacemaker lead placement in patients with complex congenital heart disease such as extracardiac Fontan circulation.
Demonstrates procedural feasibility in complex CHD; hypothesis-generating and requires prospective validation before clinical adoption.
Given the lack of systemic venous return to the heart, palliated single ventricle patients frequently require epicardial pacemaker implantation for management of dysrhythmias including sinus node dysfunction, atrial arrhythmias, and heart block. Repeated device hardware replacement, frequently required due to high lead thresholds or other device failure, is a challenging and significant problem for this population. 3-dimensional imaging can assist in delineating the cardiac anatomy allowing for novel approaches to intervention. We review a patient with extracardiac Fontan circulation who underwent placement of an endocardial atrial pacemaker lead via a transmural approach with a 3D-printed model used for procedural guidance.
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Tunks et al. (2022) studied this question.
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