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Salvage of an Epicardial Lead in a Pacemaker-Dependent Patient with Fontan Palliation Using an IS-1 Extender.
  • +1
  • Konstantinos Aronis,
  • Bret Mettler,
  • Charles Love,
  • Caridad de la Uz
Konstantinos Aronis
Johns Hopkins Hospital
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Bret Mettler
Johns Hopkins Hospital
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Charles Love
Johns Hopkins Hospital
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Caridad de la Uz
Johns Hopkins Hospital
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Peer review status:UNDER REVIEW

12 Jun 2020Submitted to Journal of Cardiovascular Electrophysiology
13 Jun 2020Submission Checks Completed
13 Jun 2020Assigned to Editor
14 Jun 2020Reviewer(s) Assigned
05 Jul 2020Review(s) Completed, Editorial Evaluation Pending
06 Jul 2020Editorial Decision: Revise Minor
10 Jul 20201st Revision Received
10 Jul 2020Submission Checks Completed
10 Jul 2020Assigned to Editor
10 Jul 2020Reviewer(s) Assigned

Abstract

We present a case report of severed epicardial atrial lead salvage using an IS-1 lead extender. A 37-year-old male with single ventricle physiology, Fontan palliation, sinus node dysfunction, recurrent atrial tachycardias and atrial fibrillation resulting in failing Fontan physiology presented with failure of the atrial pacing lead. The patient was initially paced with an epicardial system that had to be removed due to pocket infection, and the epicardial leads were cut and abandoned. Given his significant sinus node dysfunction he required atrial pacing to allow for rhythm control. The failing Fontan physiology of the patient precluded him from undergoing surgery for epicardial lead placement or a complex intravascular lead placement procedure (although anatomically feasible). We considered the option of salvaging the existing epicardial atrial leads to provide atrial pacing, allowing for rhythm control and improvement of his failing Fontan physiology as a bridge to a more permanent pacing solution. This case report is important because it demonstrates how a lead extender can be used to salvage a severed pacemaker lead. This may be useful for patients in whom implantation of new leads is not promptly feasible due to patient anatomy and/or clinical status.