First case report in Japan of left ventricular pacing via a coronary vein in a patient with a mechanical tricuspid valve.

Transvenous endocardial pacemaker implantation is contraindicated in patients after prosthetic tricuspid valve replacement. A 65-year-old woman underwent both replacement of the mitral and tricuspid valves and pacemaker implantation with epicardial lead for bradycardia with chronic atrial fibrillation. At 2 years after this operation, the pacemaker's battery became low, and she was admitted for a battery exchange. To avoid frequent battery exchanges because of high stimulation thresholds, a left ventricular pacing lead was implanted via a coronary vein. There were no complications and the stimulation thresholds were stable. Coronary vein leads enable a minimally invasive approach, improve safety, and give effective stimulation for patients with a prosthetic tricuspid valve. This is the first case report in Japan of left ventricular pacing in such a patient.