Permanent pacing in a patient with tricuspid prosthesis – Widening therapeutic use of coronary sinus

Abstract Unconventional sites are being used for pacing in patients with inaccessible right ventricle like single ventricle, atresia of tricuspid valve and in anomalous venous drainage. Here we report a case in which the right ventricle could not be accessed due to the metallic prosthesis. A 41-year...

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Bibliographic Details
Published in:Indian heart journal 2013-09, Vol.65 (5), p.611-613
Main Authors: Vijayakumar, Maniyal, Kamath, Prakash, Pai, Praveen G
Format: Article
Language:English
Subjects:
Adult
Bradycardia - diagnosis
Bradycardia - etiology
Bradycardia - therapy
Cardiac Catheterization - methods
Cardiac Pacing, Artificial - methods
Cardiovascular
Case Report
Coronary Sinus
Electrocardiography - methods
Female
Follow-Up Studies
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation - adverse effects
Heart Valve Prosthesis Implantation - methods
Humans
Inaccessible right ventricle
Permanent pacing
Postoperative Complications - diagnosis
Postoperative Complications - therapy
Rheumatic Heart Disease - diagnosis
Rheumatic Heart Disease - surgery
Risk Assessment
Treatment Outcome
Tricuspid prosthesis
Tricuspid Valve Insufficiency - diagnostic imaging
Tricuspid Valve Insufficiency - surgery
Ultrasonography
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Summary:Abstract Unconventional sites are being used for pacing in patients with inaccessible right ventricle like single ventricle, atresia of tricuspid valve and in anomalous venous drainage. Here we report a case in which the right ventricle could not be accessed due to the metallic prosthesis. A 41-year-old lady required triple valve replacement for rheumatic involvement. Permanent pacemaker implantation was done with epicardial lead for bradycardia post operatively. Pulse generator change was needed within 3 years as the pacemaker reached end of life due to high lead threshold. Subsequent pacemaker implantation was done with a left ventricular lead in coronary sinus by percutaneous approach. One year after implantation, the threshold remains stable. Coronary sinus can be utilized for permanent pacing in patients with inaccessible right ventricle due to prosthetic tricuspid valve.
ISSN:0019-4832
DOI:10.1016/j.ihj.2013.08.012