Key Teaching Points
- Sinus node dysfunction and the need for atrial pacing is common in
patients with Fontan palliation, but pacemaker implantation is
challenging as the venous circulation is directed in the pulmonary
arteries bypassing the systemic atrium.
- Lead extenders can be used to salvage severed pacemaker leads in
patients for whom implantation of new leads is not promptly feasible
due to their anatomy and/or clinical status.
- Bipolar IS-1 lead extenders can be used even if only the anode of a
severed lead can be recovered, with adequate unipolar sensing and
pacing.
- Lead salvage with IS-1 lead extenders is not recommended for patients
who are pacemaker-dependent, or as a durable solution for any patient,
but rather as a temporizing intervention.