LATE ENDOCARDIAL PACING LEAD BODY MIGRATION COMPROMISING FONTAN PHYSIOLOGY

Migration of intracardiac transvenous pacing leads may occur. There is a known risk of intrapulmonary ventricular pacing lead migration in p atients with endocardial lead systems. In the current report we presen t the late intrapulmonary migration of an endocardial atrial pacing le ad body. The patient had undergone antitachycardia pacemaker placement to control recurrent atrial tachyarrhythmias following the Fontan pro cedure. Although the lead electrode remained in place and continued to pace, the lead body migrated, causing severe obstruction to bloodflow . This resulted in severe cardiac decompensation, which was ultimately ameliorated by lead repositioning.