Three-dimensional electroanatomic voltage map-guided treatment of a patient with a failing atriopulmonary fontan circulation.
A three-dimensional electroanatomic bipolar voltage map of the right atrium was performed in a 20-year-old patient with functional single-ventricle physiology after a classic Fontan-type operation who presented with clinical signs of heart failure, a dilated right atrium, protein-losing enteropathy, and sinus node dysfunction. Previous pacemaker upgrading to a DDD system using a transvenous right atrial lead had failed due to insufficient sensing and pacing function. The voltage map showed large zones of scarring and low-amplitude signals. Consecutively, conversion to an extracardiac total cavopulmonary connection (TCPC) together with a pacing lead insertion into the left atrium was performed successfully.
Schreiber
Christian
C
Clinic of Cardiovascular Surgery, German Heart Center-Munich at the Technical University, Lazarettstrasse 36, 80636 Munich, Germany. schreiber@dhm.mhn.de
Hessling
Gabriele
G
Zrenner
Bernhard
B
Prodan
Zsolt
Z
Lei
Li
L
Eicken
Andreas
A
Lange
Rüdiger
R
D000328:Adult; D018780:Body Surface Potential Mapping / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D018729:Fontan Procedure / Q000009:adverse effects*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D016896:Treatment Outcome