Journal of Arrhythmia (2011-01-01)

Ventricular Pacing via the Coronary Sinus in a Patient with a Mechanical Tricuspid Valve Prosthesis

  • Janice Swampillai, MD,
  • Spencer C. Heald, MD,
  • Gerard P. Devlin, MD,
  • Martin K. Stiles, MD

Journal volume & issue
Vol. 27, no. 4
pp. 343 – 346


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Implantation of a transvenous endocardial pacing lead in the right ventricle is contra-indicated after mechanical tricuspid valve replacement; therefore a surgical approach to the epicardium is usually required. This case report describes ventricular pacing via a branch of the coronary sinus in a patient with mechanical mitral, aortic and tricuspid valve replacements. In conclusion, this approach is minimally invasive, provides effective ventricular stimulation with low pacing threshold and stable lead position, and is a feasible option when transvenous right ventricular pacing is not possible.