Permanent pacemaker implantation via coronary sinus.
10.4070/kcj.1998.28.2.304
- Author:
Hyun Suk CHOI
;
Myung Yong LEE
;
Moo Yong LEE
;
Seong Choon CHOE
;
Young Jin CHOI
;
Hyo Soo KIM
;
Dae Won SOHN
;
Byung Hee OH
;
Myung Mook LEE
;
Young Bae PARK
;
Yun Shik CHOI
;
Young Woo LEE
- Publication Type:Original Article
- Keywords:
Complete AV block;
Permanent Pacemaker;
Coronary Sinus
- MeSH:
Adult;
Atrioventricular Block;
Coronary Sinus*;
Dizziness;
Electrodes;
Female;
Humans;
Mitral Valve;
Prednisolone;
Syncope;
Thoracotomy;
Tricuspid Valve;
Veins
- From:Korean Circulation Journal
1998;28(2):304-308
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We report a case of successful ventricular pacing via the coronary sinus in a 34 year-old female patient admitted because of repetitive dizziness and syncope. She had rheumatic valvular disease with mitral valve replacement 14 years earlyer. and the mitral, aortic and tricuspid valves were subsequently replaced with prosthetic mechanical valves 4 years ago. Two years after the triple valve replacement, complete AV block developed with the symptoms of dizziness and syncope. A permanent pacemaker was implanted epicardially. Six months later the epicardial lead was replaced because of increased pacing threshold. A year later the epicardial lead had to be replaced because of increased threshold and capture failure to pace. To avoid further thoracotomy, a 'Medtronic 2188' electrode was implanted in the posterior left ventricular vein via the coronary sinus. Pacing threshold was 1.2 volt/0.4 msec. Five days later, the pacing threshold increased to 3.0 volt/0.4 msec. Prednisolone had been given for 10 months. The new system has been functioning well and the pacing threshold was 1.0 volt/0.4 msec at 11 months after implantation. Ventricular pacing via the coronary sinus can be an alternative to the epicardial pacemaker system in patient whose tricuspid valve have been replaced with mechanical prosthetic valve.