Successful Use of Transvenous Atrial and Bifocal Left Ventricular Pacing in Ebstein’s Anomaly After Tricuspid Prosthetic Valve Surgery J. Alberto Lopez,

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Successful Use of Transvenous Atrial and Bifocal Left Ventricular Pacing in Ebstein’s Anomaly After Tricuspid Prosthetic Valve Surgery J. Alberto Lopez, MD, D. Richard Leachman, MD The Annals of Thoracic Surgery Volume 83, Issue 3, Pages 1183-1185 (March 2007) DOI: 10.1016/j.athoracsur.2006.08.011 Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Chest roentgenogram in the posteroanterior and lateral projections shows the atrial lead at the interatrial septum (left) and two leads in the coronary sinus with bipolar electrodes in the anterior cardiac vein and a posterolateral branch (right). The Annals of Thoracic Surgery 2007 83, 1183-1185DOI: (10.1016/j.athoracsur.2006.08.011) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Continuous-wave Doppler image, obtained at the left ventricular (LV) outflow tract (left) and right ventricular (RV) outflow tract (right), show preejection times and no right-to-left ventricular delay (mechanical interventricular synchrony). (ICT = isovolumetric contraction time.) The Annals of Thoracic Surgery 2007 83, 1183-1185DOI: (10.1016/j.athoracsur.2006.08.011) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Tissue Doppler images of the lateral and septal walls (left and right views, respectively) at the mitral valve annulus show no significant delay to the peak systolic myocardial velocity in the left ventricle (mechanical intraventricular synchrony). (TD = tissue Doppler.) The Annals of Thoracic Surgery 2007 83, 1183-1185DOI: (10.1016/j.athoracsur.2006.08.011) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions