Pacing in the middle cardiac vein in a patient with tricuspid prosthesis.
A man with acute endocarditis developed complete heart block several days after the tricuspid and aortic valve replacement. Several weeks after implantation, his epimyocardial pacing leads developed a high threshold and failed to capture the ventricle at the maximal pulse width and output of the pacemaker. An angled-tip lead was placed in the middle cardiac vein for ventricular pacing. The pacing and sensing thresholds of this lead were within the expected range during follow-up. Therefore, in patients with prosthetic tricuspid valve, pacing in the middle cardiac vein should be considered before open-chest placement of the epimyocardial lead.
Nguyen
Luc S
LS
Department of Cardiology, Fountain Valley Regional Hospital, California, USA. lucsinh@dnamail.com
Swaroop
Satinder
S
Prejean
Curtis A
CA
D000328:Adult; D001705:Bioprosthesis; D002304:Cardiac Pacing, Artificial; D003331:Coronary Vessels; D004567:Electrodes, Implanted; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D014261:Tricuspid Valve