Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
March 21, 2025JACC AdvancesOpen Access

Novel and multisite pacing may mitigate the detrimental effects of ventricular pacing in Fontan patients.

View Full Paper
Ask AI
Bookmark
Share

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

BPBret L. PinskerJMJeremy P. MooreTBThomas M. Bashore

Discussion

Loading...

Member takes

Overview

May inform pacing choices in Fontan patients; leaves open benefits of novel techniques pending prospective trials.

Structured PICO

P
Population
Patients who have undergone the Fontan operation with electrophysiologic abnormalities (sinus node dysfunction, complete atrioventricular block, and electromechanical dyssynchrony) requiring pacemaker implantation
I
Intervention
Permanent cardiac pacing (epicardial or transvenous pacemaker implantation)

This review outlines the indications, challenges, and outcomes of permanent cardiac pacing in the Fontan population, highlighting epicardial lead placement as the default approach.

Limitations

  • Limited data on long-term clinical outcomes of atrial pacing after the Fontan operation.
  • Clinical studies of cardiac resynchronization therapy in Fontan patients have been underpowered to detect differences in important clinical outcomes.
  • Formal comparisons of lateral tunnel and extracardiac approaches have been limited by short follow-up and variability in surgical strategies.

Cite This Study

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.

synapsesocial.com/papers/6a17db6f819538fab739e36ehttps://doi.org/10.1016/j.jacadv.2025.101667
View Full Paper
Ask AI
Bookmark
Share