Ventricular lead malfunction in a patient with complete atrioventricular block and corrected transposition of the great arteries: Is leadless pacemaker the best solution?

Unlabelled: Corrected transposition of the great arteries (c-TGA) is a congenital abnormality characterized by atrioventricular (AV) and ventriculoarterial discordance, associated with early and late-onset conduction disturbances. We report the case of a c-TGA patient affected by congenital complete AV block, with right ventricular lead malfunction with prolonged dwell time and two abandoned leads. He underwent leadless VDD pacemaker implantation at an unusual site (i.e. the anterior wall of subpulmonic left ventricle), with an optimal electrical performance, a good AV synchrony, and QRS narrowing.

Learning Objective: Leadless VDD pacing is safe and feasible in patients affected by corrected transposition of the great arteries, even with an unusual implant site such as the anterior wall of subpulmonic left ventricle.