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When monitoring patients, it is important to obtain values that are accurate and reliable. Blood pressure monitoring is one of the essential vital signs, and for a majority of patients, measuring it utilizing non-invasive techniques provides accurate values. However, there are situations in which the blood pressure requires more exact, specific, and reliable measurements....
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Related Experiment Video

Updated: Jan 20, 2026

Arterial Line Placement: Over-the-Wire and Over-the-Needle
06:57

Arterial Line Placement: Over-the-Wire and Over-the-Needle

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Voltage mapping to guide pacemaker placement in patients with CHD.

Soham Dasgupta1, Peter Fischbach1, Robert Whitehill1

  • 1Division of Pediatric Cardiology, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA.

Cardiology in the Young
|September 3, 2019
PubMed
Summary

Pacemaker implantation in Fontan patients is challenging. Advanced electro-anatomic mapping successfully guided lead placement within the Fontan baffle, offering a new approach for complex congenital heart disease.

Keywords:
FontanPacemakerepicardialtransvenous

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Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Cardiac Electrophysiology

Background:

  • Sinus node dysfunction management in Fontan palliation is complex.
  • Transvenous pacemaker implantation faces challenges due to limited pacing tissue and obstruction risk in low-flow Fontan circuits.

Observation:

  • A case study involving a patient with Fontan palliation requiring pacemaker implantation.
  • The patient presented with sinus node dysfunction, necessitating a transvenous pacing solution.

Findings:

  • Electro-anatomic voltage mapping was utilized to precisely guide the transvenous single-chamber lead placement.
  • Successful lead implantation was achieved within the Fontan baffle, avoiding vascular obstruction.

Implications:

  • This case demonstrates the utility of advanced mapping technologies in complex cyanotic heart disease.
  • Electro-anatomic mapping offers a viable strategy for challenging pacemaker implantations in Fontan patients.
  • Improved outcomes for patients with congenital heart disease requiring cardiac pacing.