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First Confirmed Case of Leadless Pacemaker Insertion via Bidirectional Glenn Shunt in Ebstein's Anomaly: A Novel Approach to Pacing Challenges

Year: 2025

Type: article

Abstract: BACKGROUND: Ebstein's anomaly presents unique pacing challenges due to complex anatomy and surgical history, often leading to transvenous lead complications. CASE PRESENTATION: A 28-year-old male with Ebstein's anomaly, prior Danielson tricuspid valve repair, and bidirectional Glenn shunt presented with acute ventricular pacing loss from dislodgment of a 4 French SelectSecure Medtronic 3830 lead into the left upper lobe pulmonary artery. An urgent procedure involved inserting an Abbott AVEIR VR leadless pacemaker via the Glenn shunt to the right ventricular apex, achieving stable thresholds (pacing threshold 0.5 V at 0.4 ms, R-wave 8 mV). Multimodal imaging (radiographs, fluoroscopy, angiography, echocardiography) confirmed device position and preserved right ventricular function. CONCLUSIONS: This first confirmed case demonstrates the feasibility and safety of leadless pacemaker insertion via Glenn shunt in complex congenital heart disease, providing a durable alternative to transvenous systems prone to dislodgment.

Source: Journal of Cardiovascular Electrophysiology

DOI: 10.1111/jce.70165

Authors: Robert S. Doyle, Hugo C. Temperley, Cian Murray, Kevin Walsh

Institutions: Mater Misericordiae University Hospital, St. James's Hospital

Language: English

Topic: Cardiac pacing and defibrillation studies

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,500