Radiation-free nonselective His pacing lead implantation in a pregnant patient with congenitally corrected transposition of the great arteries

Abstract

At present, in the absence of adequate echocardiographic images, fluoroscopy is still Introduction His-bundle pacing may offer a more physiologic ventricular activation sequence and avoid some of the adverse effects associated with chronic right ventricular (RV) pacing. This may be of particular importance in the context of reduced systemic ventricular function. There is a strong motivation to reduce radiation exposure during pregnancy to minimize the risk of adverse events resulting from fetal radiation exposure. We present a patient with L-type congenitally corrected transposition of the great arteries (L-CCTGA) who presented with symptomatic atrioventricular (AV) conduction block at 25 weeks’ gestation. We elected to proceed to His-bundle pacemaker implant with minimal use of fluoroscopy to achieve physiologic pacing while minimizing the risk to the developing fetus. required to assess lead slack prior to fixation.