Why the study?
Following the Fontan operation, electrophysiologic abnormalities requiring pacemaker implantation are common, but pacing can be challenging, increases thromboembolism risk via transvenous access, and has been associated with poor outcomes.
Population
Fontan patients requiring permanent cardiac pacing
Design
Review
Key result
Permanent cardiac pacing is frequently required in Fontan patients, and while ventricular pacing can be detrimental, novel techniques and multisite pacing may mitigate these adverse effects.
Authors
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May inform pacing choices in Fontan patients; leaves open benefits of novel techniques pending prospective trials.
This review outlines the indications, challenges, and outcomes of permanent cardiac pacing in the Fontan population, highlighting epicardial lead placement as the default approach.
Pinsker et al. (2025) conducted a review in Fontan physiology with bradyarrhythmia. Permanent Cardiac Pacing was evaluated. Permanent cardiac pacing is frequently required in Fontan patients, and while ventricular pacing can be detrimental, novel techniques and multisite pacing may mitigate these adverse effects.