Transvenous left atrial and left ventricular pacing in Ebstein's anomaly with severe interatrial conduction block.

The implantation of permanent pacemakers in patients with congenital heart disease can be challenging. This report describes the complexity of pacemaker implantation in a patient with Ebstein's disease, tricuspid valve replacement, and right atrial abnormalities like severe intra- and interatrial conduction block that prevented dual chamber pacing from conventional sites. This case illustrates the promising possibility to circumvent the interatrial conduction block with single left atrial pacing instead of biatrial pacing which was not suitable here.