Variation in optimal hemodynamic atrio-ventricular delay of biventricular pacing with different endocardial left ventricular lead locations using precision hemodynamics.

Introduction: It is not known whether the optimal atrioventricular (AV ) delay varies between left ventricular (LV) pacing site during endocardial biventricular pacing (BiVP) and may therefore needs consideration.

Methods: We assessed the hemodynamic AV in patients with chronic heart failure undergoing endocardial LV lead implantation. AV was assessed during atrio-BiVP with a "roving LV lead.

A novel and unique treatment of right ventricular inflow obstruction in a patient with a Bjork modification of the Fontan palliation before pregnancy.

Introduction: Patients with complex congenital cardiac disease are increasingly surviving to adulthood and many are keen to consider pregnancy. Haemodynamic status should be optimal prior to embarking on pregnancy and for some this may mean surgical intervention to alleviate haemodynamic residua.

Methods: We report the successful implantation of a percutaneous pulmonary stent valve into a right atrial to right ventricular conduit in a young woman with a Bjork modification of the Fontan palliation to improve haemodynamics prior pregnancy.