title: Successful long-term ventricular pacing via the coronary sinus after the Fontan operation.
abstract: A man with double inlet left ventricle and severe subpulmonary stenosis underwent a Fontan operation at the age of 29 years. Eight years later he developed atrial flutter with complete heart block. To avoid a further thoracotomy, a unipolar carbon tipped electrode was placed into the posterior cardiac vein via the coronary sinus. More than 8 years after implantation of the original lead, and after two generator changes, telemetric thresholds remain between 1.8-2.1 volts. Percutaneous transvenous ventricular pacing via the coronary sinus can produce an excellent long-term result and should be the initial approach of choice after a Fontan-type operation.
authors.affiliation: Department of Paediatric Cardiology, Guy's Hospital, London, United Kingdom.
authors.forename: E
authors.initials: E
authors.lastname: Rosenthal
authors.forename: S A
authors.initials: SA
authors.lastname: Qureshi
authors.forename: J C
authors.initials: JC
authors.lastname: Crick
mesh_terms: D000328:Adult; D001282:Atrial Flutter / Q000628:therapy; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D003331:Coronary Vessels; D005500:Follow-Up Studies; D018729:Fontan Procedure; D006327:Heart Block / Q000628:therapy; D006352:Heart Ventricles / Q000002:abnormalities / Q000601:surgery; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D011666:Pulmonary Valve Stenosis / Q000601:surgery