title: Transvenous bifocal left ventricular pacing after mechanical prosthetic tricuspid valve replacement with use of echocardiography to optimize pacing parameters.
abstract: A 56-year-old woman underwent placement of a permanent pacemaker to treat symptomatic bradycardia; she had a documented, severe atrioventricular (AV) conduction abnormality and was not taking any AV node-blocking drugs. She had a mechanical prosthetic valve in the tricuspid position, which had been implanted for severe valvular insufficiency caused by rheumatic heart disease. Pacing leads were successfully placed transvenously in the anterior cardiac and a posterolateral vein, which avoided the need for repeat thoracotomy. Echocardiographic and Doppler parameters were used to optimize interventricular as well as septal-to-lateral left ventricular (LV) time delay and reduce or avoid interventricular and LV mechanical dyssynchrony.
authors.affiliation: Texas Heart Institute at St. Luke's Episcopal Hospital and Baylor College of Medicine, Houston, TX 77030, USA. jalopez@bcm.tmc.edu
authors.forename: J Alberto
authors.initials: JA
authors.lastname: Lopez
authors.forename: Roberto
authors.initials: R
authors.lastname: Lufschanowski
mesh_terms: D001919:Bradycardia / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004452:Echocardiography; D005260:Female; D006327:Heart Block / Q000628:therapy*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D014261:Tricuspid Valve / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000601:surgery*