Left ventricular epicardial VVI pacing for a congenital complete heart block with severe myocardial dysfunction: shall epicardial pacing wires be positioned left?
We present the case of a patient with a congenital complete heart block (CHB) who developed a severe dilated hypokinetic cardiomyopathy whilst paced with a right-sided epicardial wire inserted by an anterior approach. She dramatically and rapidly improved both clinically and echocardiographically, once a single pacing wire was inserted on the left ventricular (LV) wall towards the apex by left thoracotomy. Based upon recent literature, attention is drawn to the fact that left-inserted epicardial pacing wires should probably be considered for pediatric patients in whom atrio-ventricular or inter-ventricular pacing might not be possible to achieve, or else as a consistent approach for small patients requiring VVI epicardial pacing.
Tissot
Cécile
C
Aggoun
Yacine
Y
Rimensberger
Peter C
PC
Sierra
Jorge
J
Kalangos
Afksendyios
A
Beghetti
Maurice
M
da Cruz
Eduardo
E
D002304:Cardiac Pacing, Artificial / Q000379:methods*; D009202:Cardiomyopathies / Q000150:complications / Q000151:congenital* / Q000628:therapy*; D005260:Female; D006327:Heart Block / Q000150:complications / Q000151:congenital* / Q000628:therapy*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D010138:Pacemaker, Artificial; D010496:Pericardium / Q000601:surgery; D019919:Prosthesis Implantation / Q000379:methods; D016896:Treatment Outcome