Heart Block in Unpalliated Complex Adult Congenital Heart Disease: Massive Collateral Burden Precludes Epicardial Pacemaker

JACC Case Rep. 2021 Jan 6;3(2):192-193. doi: 10.1016/j.jaccas.2020.10.019. eCollection 2021 Feb.


Complete heart block is a common complication for adults with congenital heart disease (CHD). Epicardial pacing is preferred in patients with septal shunting due to risk of thromboembolism. Anatomic changes in complex CHD may preclude surgical epicardial lead placement. Thromboembolism risk reduction in such patients requiring endocardial pacing remains questionable. (Level of Difficulty: Advanced.).

Keywords: AV, atrioventricular; CHD, congenital heart disease; CT, computed tomography; bradycardia; cardiac pacemaker; computed tomography; cyanotic heart disease; stroke; ventricular septal defect.