title: Right ventricular lead implantation facilitated by a guiding sheath in a patient with severe chamber dilatation with tricuspid regurgitation.
abstract: Implantation of pacemakers can be challenging in the context of dilated cardiac chambers and valvular regurgitation. We report a difficult case of single chamber pacemaker implantation in a patient with restrictrive cardiomyopathy resulting in grossly enlarged atria and severe tricuspid regurgitation. In this situation, use of a slittable guiding sheath, more typically used for coronary sinus lead implantation, greatly facilitated rapid and stable deployment of the right ventricular lead.
authors: Department of Cardiac Electrophysiology, Imperial College Healthcare NHS Trust, Cardiology Department, St Mary's Hospital, Pread Street, London W2 1NY.
authors: Phang Boon
authors: PB
authors: Lim
authors: David C
authors: DC
authors: Lefroy