1. INTRODUCTION
Multiple congenital heart diseases have progressive conduction
disorders, either intrinsic or developed through reparative
surgeries.1 In particular, univentricular hearts are
more associated with bradyarrhythmias and complete heart block. Many of
these patients need a permanent pacemaker.2 In
univentricular hearts, epicardial pacing has been the first option
because of the limited venous access. Also, in the presence of
intracardiac shunts, it is the preferred method since there is an
increased risk of systemic thromboembolism with the endocardial
route.1-3 However, epicardial leads have considerable
disadvantages. One of them is that they have higher chronic pacing
thresholds and reduced generator longevity, although this may be
improved with the usage of steroid-eluting epicardial leads. Another
problem is invasive surgeries used for implanting these
leads.4,5 The present report explains the implantation
of a permanent endocardial pacemaker in an adult patient with tricuspid
atresia type IIc with severe pulmonary hypertension and complete heart
block.