Case report demonstrating novel approaches for leadless pacemaker implantation in the single ventricle heart.

BACKGROUND

The congenital heart disease population can provide a unique set of challenges during pacemaker implant, including the necessity of transvenous leads in a young group of patients. In this case report we demonstrate how leadless pacemakers may be used as an option in patients with Fontan circulation.

CASE SUMMARY: We present two cases of novel use of the Abbott AVEIR™ leadless pacemaker, including the first reported in person trans-baffle delivery of this device and implantation into a single ventricle heart. Our cases are a 30-year-old male with single ventricle physiology and Fontan circulation, found incidentally to have complete heart block (CHB) and a 48-year-old female with a Fontan circulation who had CHB and a history of syncope. These cases demonstrate a variety of venous access routes and add to the existing data of leadless pacemaker implantation in single ventricle physiology. The very long battery life of these devices make them ideal for patients with difficult venous access with bradycardia pacing requirement with low pacing burden.

DISCUSSION: Leadless pacemakers offer a valuable alternative to transvenous pacing leads for providing bradycardia pacing support in this patient population.