title: Transatrial permanent pacing lead implantation in a patient of Ebstein's anomaly after one and half repair.
abstract: Several innovative approaches have been described to achieve endocardial pacing in patients with operated complex congenital heart diseases. We report herein a case of Ebstein's anomaly who underwent a Hardy's repair with a bidirectional Glenn shunt, tricuspid valve annuloplasty and atrial septal defect closure following which she developed complete heart block. The chest was reopened through the previous midsternotomy and a screw-in lead implanted transatrially that resulted in optimal pacing thresholds. This technique offers a viable alternative for endocardial pacing in peri-operative patients requiring permanent pacing.
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi. rjuneja2@rediffmail.com
authors.forename: Rajnish
authors.initials: R
authors.lastname: Juneja
authors.forename: Anita
authors.initials: A
authors.lastname: Saxena
authors.forename: Shiv
authors.initials: S
authors.lastname: Choudhary
authors.forename: Balram
authors.initials: B
authors.lastname: Airan
mesh_terms: D000328:Adult; D002304:Cardiac Pacing, Artificial; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology; D004437:Ebstein Anomaly / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D011859:Radiography