Inflammation and Rupture of a Congenital Pericardial Cyst Manifesting Itself as an Acute Chest Pain Syndrome.

We present the case of a 63-year-old woman with a remote history of supraventricular tachycardia and hyperlipidemia, who presented with recurrent episodes of acute-onset chest pain. An electrocardiogram showed no evidence of acute coronary syndrome. A chest radiograph revealed a prominent right-sided heart border.

A novel approach to transvenous dual-chamber pacing lead placement and cardiac defibrillator implantation after tricuspid valve replacement.

Pacing and Defibrillation Therapy. We report the successful use of a percutaneous, totally transvenous endocardial approach to atrioventricular pacing and internal cardiac defibrillation in an adult patient with tetralogy of Fallot who had undergone three previous cardiac operations, including a tricuspid valve replacement. Ventricular pacing and sensing were achieved with a bipolar lead in the lateral cardiac vein, and atrial pacing was attained in the region of Bachmann's bundle.

Use of a transvenous dual-chamber ICD after a mustard operation for d-transposition of the great vessels.

A 40-year-old man was admitted to our institution with mild heart failure symptoms, including palpitations and near syncope. Twenty-eight years earlier, he had undergone a Mustard operation to correct d-transposition of the great vessels. At the present admission, echocardiography revealed severe right (systemic) ventricular dysfunction.

Transvenous bifocal left ventricular pacing after mechanical prosthetic tricuspid valve replacement with use of echocardiography to optimize pacing parameters.

A 56-year-old woman underwent placement of a permanent pacemaker to treat symptomatic bradycardia; she had a documented, severe atrioventricular (AV) conduction abnormality and was not taking any AV node-blocking drugs. She had a mechanical prosthetic valve in the tricuspid position, which had been implanted for severe valvular insufficiency caused by rheumatic heart disease. Pacing leads were successfully placed transvenously in the anterior cardiac and a posterolateral vein, which avoided the need for repeat thoracotomy.