Introduction: RV failure is an important cause of late morbidity and mortality in patients who have undergone TOF correction. Hence, biventricular pacing has been proposed to improve cardiac contractility.
Case Report : 10 years old boy diagnosed with TOF andinfundibular PS underwent TOF repair with preserved PV at 4 years of age. Initial post-operative ECG showed RBBB with 2nd degree heart block and supported with DDD mode temporary pacemaker. Over time, patient developed intermittent AV block and prior to discharge, echocardiography showed good LV function with no residual PS and VSD. Late onset complete heart block was detected 4 years post-surgery and he was noted to have RV failuredespite being asymptomatic. Dual chamber apical LV pacemaker was planned. However, there are issues pertaining to the implantation approach in relation to RV failure. RBBB was known to affect conduction in both ventricles progressively. Hence, biventricular pacing was subjected to improve RV function and provide synchronization of both ventricles.
Conclusions: Biventricular pacing is feasible in post TOF repair withRV failure.