Permanent ventricular pacing from coronary sinus after Fontan operation using newly designed left ventricular lead

The functional single ventricles in Fontan procedures are isolated from the systemic return and thereby precluding conventional endocardial ventricular pacing. We reported a young patient who underwent Fontan operation at the age of 8 years old. He presented with significant bradyarrhythmias 13 years later requiring pacing therapy. A specially designed self-retained left ventricular (LV) pacing lead was implanted successfully through the coronary sinus and its anterolateral branch with satisfactory and stable chronic thresholds by one year's follow-up.