SUCCESSFUL LONG-TERM VENTRICULAR PACING VIA THE CORONARY SINUS AFTER THE FONTAN OPERATION

A man with double inlet left ventricle and severe subpulmonary stenosi s underwent a Fontan operation at the age of 29 years. Eight years lat er he developed atrial flutter with complete heart block. To avoid a f urther thoracotomy, a unipolar carbon tipped electrode was placed into the posterior cardiac vein via the coronary sinus. More than 8 years after implantation of the original lead, and after two generator chang es, telemetric thresholds remain between 1.8-2.1 volts. Percutaneous t ransvenous ventricular pacing via the coronary sinus can produce an ex cellent long-term result and should be the initial approach of choice after a Fontan-type operation.