title: Transvenous permanent pacemaker implantation in dextrocardia: technique, challenges, outcome, and a brief review of literature.
abstract: OBJECTIVE
  Dextrocardia is a rare congenital anomaly. Pacemaker implantation in dextrocardia can be challenging because of the distorted anatomy and associated anomalies. The literature regarding implantation of pacemaker in dextrocardia is scarce.
  
  
  RESULTS
  The study involved retrospective analysis of records of patients with dextrocardia who had undergone pacemaker implantation between January 2006 and July 2013 from a single centre. Six patients with dextrocardia (five males and one female) underwent permanent pacemaker implantation (PPI) between January 2006 and July 2013. Of them, three had situs solitus dextrocardia and three situs inversus dextrocardia. All three patients with situs solitus dextrocardia had associated corrected transposition of great arteries. The indication for pacemaker implantation was symptomatic complete atrioventricular (AV) block in four, high-grade AV block in one, and sinus node dysfunction in one patient. A favourable outcome was noted during a mean follow-up of 3.9 years (4 months to 7 years) with one patient needing a pulse generator replacement.
  
  
  CONCLUSIONS
  Permanent pacemaker implantation in dextrocardia can be challenging because of the distorted anatomy. Use of a technique employing angiography to delineate chamber anatomy and relationship can assist the operator during such difficult PPIs. The medium- and long-term survival after a successful pacemaker implantation in dextrocardia is favourable.
authors.affiliation: Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bannerghatta Road, Jayanagar 9th Block, Bangalore 560069, Karnataka, India jshenthar@yahoo.com.
authors.forename: Jayaprakash
authors.initials: J
authors.lastname: Shenthar
authors.affiliation: Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bannerghatta Road, Jayanagar 9th Block, Bangalore 560069, Karnataka, India.
authors.forename: Maneesh K
authors.initials: MK
authors.lastname: Rai
authors.affiliation: Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bannerghatta Road, Jayanagar 9th Block, Bangalore 560069, Karnataka, India.
authors.forename: Rohit
authors.initials: R
authors.lastname: Walia
authors.affiliation: Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bannerghatta Road, Jayanagar 9th Block, Bangalore 560069, Karnataka, India.
authors.forename: Somasekhar
authors.initials: S
authors.lastname: Ghanta
authors.affiliation: Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bannerghatta Road, Jayanagar 9th Block, Bangalore 560069, Karnataka, India.
authors.forename: Praveen
authors.initials: P
authors.lastname: Sreekumar
authors.affiliation: Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bannerghatta Road, Jayanagar 9th Block, Bangalore 560069, Karnataka, India.
authors.forename: Satish S
authors.initials: SS
authors.lastname: Reddy
mesh_terms: D000328:Adult; D000368:Aged; D054537:Atrioventricular Block / Q000150:complications / Q000628:therapy*; D003914:Dextrocardia / Q000150:complications / Q000628:therapy*; D005268:Femoral Vein; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome
keywords: Complete heart block; Congenital heart disease; Corrected transposition of great arteries; Permanent pacemaker implantation; Situs solitus dextrocardia