title: The pulmonary artery lasso: epicardial pacing lead causing right ventricular outflow obstruction.
abstract: Permanent pacing in small children may require placement of an epicardial pacing system. This report describes a young child who underwent pacemaker implantation with epicardial ventricular lead placement in infancy as an adjunct to antiarrhythmic therapy for congenital junctional ectopic tachycardia. At 5 years of age, a harsh systolic murmur was detected for the first time. Evaluation by catheterization and transluminal echocardiography showed right ventricular outflow obstruction (pressure gradient 40 mmHg) secondary to extrinsic compression by the epicardial lead. Surgical removal of the lead relieved the obstruction.
authors.affiliation: Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Houston 77225.
authors.forename: J C
authors.initials: JC
authors.lastname: Perry
authors.forename: M R
authors.initials: MR
authors.lastname: Nihill
authors.forename: A
authors.initials: A
authors.lastname: Ludomirsky
authors.forename: D A
authors.initials: DA
authors.lastname: Ott
authors.forename: A
authors.initials: A
authors.lastname: Garson
mesh_terms: D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D002675:Child, Preschool; D004567:Electrodes, Implanted; D004868:Equipment Failure; D006327:Heart Block / Q000209:etiology; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D011651:Pulmonary Artery; D013613:Tachycardia, Ectopic Junctional / Q000628:therapy; D013617:Tachycardia, Supraventricular / Q000628:therapy; D014694:Ventricular Outflow Obstruction / Q000209:etiology* / Q000601:surgery