Coronary sinus pacing can be an effective alternative for left atrial pacing in patients with an ICD who experience oversensing with right atrial lead placement.
May support coronary sinus pacing as bailout for ICD atrial oversensing; hypothesis-generating case report requiring prospective validation.
A woman with an ICD underwent permanent pacemaker implantation for bradycardia-tachycardia syndrome. Despite multiple right atrial positions, oversensing secondary to "double counting" was always noted. A coronary sinus pacing catheter was inserted and left atrial pacing was accomplished with acceptable pacing and sensing characteristics. The patient has since done well without further shocks.
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Peters et al. (1997) studied this question.
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