Novel approach to intracardiac defibrillator placement in patients with atriopulmonary Fontan: Ventricular defibrillation with an atrial positioned ICD lead
- Resource Type
- Authors
- Leonard A. Steinberg; Mathew S. Padanilam; Brad Clark; Asim Ahmed; Joshua I. Mozes
- Source
- Journal of Cardiovascular Electrophysiology. 32:3275-3278
- Subject
- medicine.medical_specialty
Defibrillation
business.industry
medicine.medical_treatment
Implantable cardioverter-defibrillator
Intracardiac injection
Fontan procedure
medicine.anatomical_structure
Ventricle
Physiology (medical)
Internal medicine
cardiovascular system
medicine
Cardiology
In patient
cardiovascular diseases
Cardiology and Cardiovascular Medicine
business
Lead Placement
Coronary sinus
- Language
- ISSN
- 1540-8167
1045-3873
INTRODUCTION The Fontan procedure, used to palliate univentricular physiology, eliminates direct venous access to the ventricle and complicates implantable cardioverter-defibrillator (ICD) placement. METHODS AND RESULTS We describe two patients with Fontan palliation who underwent a novel transvenous approach to ICD placement. The approach uses a transvenous bipolar lead placed in a coronary sinus branch for ventricular sensing, and a defibrillation lead placed in the right atrium for atrial sensing and ventricular defibrillation. CONCLUSION Transvenous ICD implantation is possible in some patients with an atriopulmonary Fontan. This approach avoids a redo sternotomy for epicardial leads and excludes the need for lead placement in the systemic circulation.