title: Successful use of a transvenous dual-chamber automatic implantable cardiac defibrillator after a classic Fontan operation for tricuspid atresia.
abstract: We report the first successful totally percutaneous pacing and defibrillation of a single ventricle in a 52-year-old woman who had undergone a classic Fontan operation (atriopulmonary connection) for tricuspid atresia 21 years earlier. Left ventricular pacing and sensing was obtained with a bipolar lead in the lateral cardiac vein, and defibrillation was obtained with a coronary sinus coil lead and an "active can" in the retromammary position to optimize the current vector. This approach has significant potential benefits because it avoids a repeat thoracotomy, with its associated mortality and morbidity.
authors.affiliation: Department of Adult Cardiology and Electrophysiology, Texas Heart Institute at St Luke's Episcopal Hospital, Houston, Texas, USA. lopezsalas@sbcglobal.net
authors.forename: J Alberto
authors.initials: JA
authors.lastname: Lopez
authors.forename: Michael
authors.initials: M
authors.lastname: Mihalick
mesh_terms: D003131:Combined Modality Therapy; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D018729:Fontan Procedure; D006801:Humans; D008875:Middle Aged; D017211:Treatment Failure; D016896:Treatment Outcome; D018785:Tricuspid Atresia / Q000150:complications* / Q000601:surgery*; D014693:Ventricular Fibrillation / Q000209:etiology* / Q000517:prevention & control*