JACC. Case reports · 2025
Arrhythmia Management in Complex Congenital Heart Disease.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mtisi Tafadzwa, Nociti Freitas Caio Fabio, Deeconda Anurag, Goyal Aditya, Malik Aysha, Blaufox Andrew D, Weinberg Catherine, Averin Konstantin, Kholwadwala Dipak H, Tugertimur Aykut, Saleh Moussa Abbas, Epstein Laurence M, Ismail Haisam
Аннотация
BACKGROUND: Atrioventricular block is a common complication in L-looped single ventricles, and it may be exacerbated by palliative surgical procedures.
CASE SUMMARY: We describe the case of a 43-year-old woman with history of double inlet left ventricle after classic Fontan procedure with subsequent Fontan revision, atrial flutter, and complete heart block managed with an epicardial pacemaker with progressive ventricular lead dysfunction. The patient was managed with leadless pacemaker implantation and atrial flutter ablation.
DISCUSSION: Epicardial pacing is the preferred modality for patients with single-ventricle physiology and atrioventricular block. However, epicardial leads have high rates of lead failure often requiring multiple lead revisions by means of thoracotomies, which carry significant morbidity. Epicardial lead revision is not always successful in patients with multiple surgeries owing to adhesions, thus alternative pacing methods are required.
TAKE-HOME MESSAGE: This case illustrates a true heart team approach in the use of leadless pacemaker and atrial flutter ablation in a patient with a complex single-functioning ventricle.
CASE SUMMARY: We describe the case of a 43-year-old woman with history of double inlet left ventricle after classic Fontan procedure with subsequent Fontan revision, atrial flutter, and complete heart block managed with an epicardial pacemaker with progressive ventricular lead dysfunction. The patient was managed with leadless pacemaker implantation and atrial flutter ablation.
DISCUSSION: Epicardial pacing is the preferred modality for patients with single-ventricle physiology and atrioventricular block. However, epicardial leads have high rates of lead failure often requiring multiple lead revisions by means of thoracotomies, which carry significant morbidity. Epicardial lead revision is not always successful in patients with multiple surgeries owing to adhesions, thus alternative pacing methods are required.
TAKE-HOME MESSAGE: This case illustrates a true heart team approach in the use of leadless pacemaker and atrial flutter ablation in a patient with a complex single-functioning ventricle.