Transvenous Establishment of a Dual-Chamber Pacing in a Patient With Total Cavopulmonary Connection Using Extracardiac Conduit.

Background: Patients are prone to bradyarrhythmias after Fontan surgery due to anatomical reasons and the surgery, whereas a transvenous approach to a cardiac chamber is difficult in patients after total cavopulmonary artery connection (TCPC) with an extracardiac conduit.

Results: We report a case of transvenous implantation of an atrial lead into the atrial roof via the pulmonary artery and a successful upgrade to the dual chamber pacing using an existing epicardial ventricular lead.

Conclusions: A transvenous approach toward atrial roof via pulmonary artery may be a possible option in patients with TCPC. If successful, high-risk additional surgery can be avoided.