title: [An effective and safe alternative to epicardial pacemaker placement for permanent pacemaker implantation in a patient with mechanical tricuspid valve: stimulation of the left ventricle through the coronary sinus].
abstract: Implantation of a transvenous endocardial pacemaker is contraindicated in patients with a mechanical tricuspid valve. An epicardial left ventricular pacemaker lead was placed by a transvenous route through the coronary sinus into the lateral cardiac vein in a 58-year-old woman with mechanical aortic, mitral, and tricuspid valves, for permanent pacing due to chronic atrial fibrillation with a slow ventricular rate accompanied by syncope. This lead was then connected to a single-chamber pacemaker. The patient had no problem in the following three months. Placement of an epicardial pacing lead through the coronary sinus provides a safe and effective pacing in patients with a mechanical tricuspid valve, thus obviating major cardiac surgery.
authors.affiliation: Department of Cardiology, Türkiye Yüksek İhtisas Heart-Education and Research Hospital, Ankara, Turkey.
authors.forename: Ahmet Duran
authors.initials: AD
authors.lastname: Demir
authors.forename: Nihat
authors.initials: N
authors.lastname: Sen
authors.forename: Ali Rıza
authors.initials: AR
authors.lastname: Erbay
authors.forename: Ramazan
authors.initials: R
authors.lastname: Atak
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000628:therapy*; D013504:Cardiovascular Surgical Procedures; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D014261:Tricuspid Valve