HeartRhythm Case Reports

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HeartRhythm Case Reports

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HeartRhythm Case Reports Permanent His-bundle pacing from the right atrium in patients with prosthetic tricuspid valve Stephanie C. Fuentes Rojas, MD, Paul A. Schurmann, MD, Moisés Rodríguez-Mañero, MD, PhD, Daniel Lustgarten, MD, PhD, FHRS, Miguel Valderrábano, MD, FACC HeartRhythm Case Reports DOI: 10.1016/j.hrcr.2019.01.009 Copyright © 2019 Terms and Conditions

Figure 1 Patient 1. A, B: Fluoroscopy depiction of deflectable sheath tip (Medtronic, Minneapolis, MN) in the area just proximal to the tricuspid valve ring. C: Delivery of SelectSecure His lead (Medtronic). D: Left anterior oblique view of SelectSecure His lead. E: Baseline electrocardiogram (ECG) prior to tricuspid valve replacement; QRSd 155 ms. F: ECG on postoperative day 2 depicting epicardial wire pacing (VVI) with underlying complete atrioventricular block; QRSd 209 ms. G: ECG postimplant depicting para-Hisian pacing (DDD with pacing output of 4.7 V at 0.5 ms); QRSd 94 ms. HeartRhythm Case Reports DOI: (10.1016/j.hrcr.2019.01.009) Copyright © 2019 Terms and Conditions

Figure 2 Patient 2. A: Fluoroscopy left anterior oblique (LAO) view of deflectable sheath tip (Medtronic, Minneapolis, MN) in the area just proximal to the tricuspid valve ring. B, C: Fluoroscopy right anterior oblique view of delivery of CapSureFix Novus lead (Medtronic). D: Fluoroscopy LAO view of CapSureFix Novus lead delivered. E: Electrocardiogram (ECG) depicting atrioventricular block after tricuspid valve replacement. F: ECG postimplant depicting selective His-bundle pacing (DDD with pacing output of 3 V at 0.5 ms and no left ventricular pacing). HeartRhythm Case Reports DOI: (10.1016/j.hrcr.2019.01.009) Copyright © 2019 Terms and Conditions