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Published on: July 18, 2014
Bifocal stimulation in patient with congenitally corrected transposition of great vessels
Giuseppe Coppola1, Claudia L Visconti, Calogero Casalicchio
1Operative Unit of Cardiology, EP Lab, Post Graduate School of Cardiology, A.O.U. Policlinico P. Giaccone, University of Palermo, Palermo 90243, Italy. g.coppola@unipa.it
Insights
Congenitally corrected transposition of the great vessels (CCTGV) can cause heart block. Bifocal cardiac pacing effectively managed a young woman with CCTGV and complex atrioventricular block.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Electrophysiology
Background:
- Congenitally corrected transposition of the great vessels (CCTGV) is a rare congenital heart defect.
- It is associated with significant cardiac morphological abnormalities and conduction defects.
- Complete atrioventricular (AV) block affects 30% of CCTGV patients, potentially developing over time.
Observation:
- A young woman with CCTGV presented with Mobitz 2 and 2:1 atrioventricular block.
- Her complex cardiac anatomy and high pacing requirements were considered.
- Bifocal cardiac stimulation was employed as a therapeutic strategy.
Findings:
- Bifocal cardiac stimulation was successfully utilized in a patient with CCTGV and complex AV block.
- This approach addressed the specific anatomical and electrophysiological challenges presented by the condition.
- The pacing strategy was tailored to the patient's unique structural and conduction abnormalities.
Implications:
- Bifocal cardiac pacing offers a viable management option for CCTGV patients with severe AV block.
- Understanding the interplay between CCTGV anatomy and conduction system is crucial for effective pacing.
- This case highlights the importance of individualized pacing strategies in complex congenital heart disease.
Abstract:
Congenitally corrected transposition of the great vessels (CCTGV) is a rare congenital heart defect associated with multiple cardiac morphological abnormalities and conduction defects. Complete atrioventricular (AV) block occurs in 30% of patients and it may be present at birth or develop later with a rate of 2% per year; moreover, a systemic right ventricle is frequently characterized by heart failure in adult life. We used a bifocal cardiac stimulation for a young woman affected by CCTGV and atrioventricular Mobitz 2 and 2:1 block, considering structural, anatomic condition, and the high rate of pacing she underwent.
