Right Bundle Branch Area Pacing in a Patient with Congenitally Corrected Transposition of the Great Arteries Using
Serkan Cay1, Hande Cetin1, Serkan Topaloglu1
1Division of Arrhythmia and Electrophysiology, Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
Abstract:
A 35-year-old man with congenitally corrected transposition of the great arteries (ccTGA) and prior ventricular septal defect repair developed pacing-induced cardiomyopathy after 30 years of single-chamber VVI pacemaker use. Right bundle branch area pacing (RBBAP) was chosen for device upgrade due to its potential benefits over conventional cardiac resynchronization therapy. Advanced three-dimensional electroanatomic mapping was employed to navigate a synthetic patch from previous surgery and guide mid-septal electrode placement. Successful RBBAP was achieved with optimal parameters, complemented by atrial and defibrillator lead implantation. At 12 months, the patient showed improved ejection fraction (from 30% to 40%) and stable electrocardiographic results. This case illustrates the role of RBBAP and advanced mapping in addressing complex structural and conduction abnormalities in ccTGA.
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