Lead configuration for defibrillator implantation in a patient with congenital heart disease and a mechanical prosthetic tricuspid valve.

The authors devised a nonthoracotomy defibrillation system for a patient with a prosthetic tricuspid valve using existing technology and previously established implantation techniques. Their lead configuration deviates substantially from existing designs in its primary use of a coronary sinus defibrillation coil and a left-sided subcutaneous array to distribute current across the ventricular myocardium.