Permanent left ventricular pacing in a patient with post-metallic tricuspid valve replacement complete heart block- a case report.

Degenerative complete heart block is a relatively common condition and is usually treated with endocardial pacing. Iatrogenic conduction disturbance is often seen after some cardiac surgical procedures. In a significant number of cases, it is irreversible and needs implantation of a pacemaker device. In this case report, we present a case of a young, severely sick patient who presented with tricuspid valve endocarditis with large vegetation. The patient was managed with surgical removal of the vegetation and replacement of the tricuspid valve with a metallic valve. Postoperatively, the patient developed complete heart block. In view of the presence of a metallic tricuspid valve, the patient was successfully managed with the implantation of a dual-chamber pacemaker using a CRT-P generator with a quadripolar lead in the posterior cardiac vein and an atrial lead in the right atrial appendage.