Permanent Pacing in a Patient With Fontan Circulation: Use All You Have at Your Discretion.

Patients with Fontan circulation post significant technical challenges at the time of permanent pacemaker implantation, as majority of them are treated with surgically implanted epicardial pacemakers. However, transvenous pacemaker implantation is technically feasible, and the treating physician should be aware of each individual's anatomy and available treatment options.