{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:08:43Z","timestamp":1789013323814,"version":"build-2803163510"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Epicardial pacemaker lead implantation in patients with univentricular circulation following total cavopulmonary connection with an extracardiac conduit and without fenestration necessitates median sternotomy. Transvenous access, although possible and previously described, may be technically challenging in this population and carries an increased risk of lead\u2010related thrombosis within the subsystemic atrium or ventricle. Surgical implantation usually requires mechanical ventilation and is associated with procedural morbidity. A percutaneous approach represents a minimally invasive treatment option that can be applied in this subgroup and in selected patients with biventricular circulation. We report on 9 patients in whom a pacemaker lead was implanted percutaneously with the use of a puncture sheath.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with pacemaker indications and anatomic constraints precluding conventional transvenous access underwent computed tomographic imaging for procedural planning. Eight patients had single\u2010ventricle physiology, and 1 patient had biventricular circulation with severely impaired ventricular function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Percutaneous pacemaker lead implantation was successful in all 9 patients. The median age was 11.2 (range, 6.0\u201343.8) years, and median weight was 22.0 (range, 19.9\u201368.5) kg. In 6 patients, the puncture was performed via the subxyphoidal approach, in 1 patient via the transthoracic approach, and in 2 patients, venous access was used (subclavian vein, n=1; internal jugular vein, n=1). The median follow\u2010up time was 26.5 (range, 0.1\u201364.8) months. Only 1 patient required reintervention for lead dysfunction after 26 months; in all others, lead thresholds remained stable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Percutaneous intramyocardial and intracavitary pacemaker lead implantation is feasible and may obviate the need for surgery. However, in selected cases, identifying a suitable landing zone may be challenging due to prior surgical interventions, scarring, or fibrosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048577","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T10:15:41Z","timestamp":1784974541000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Percutaneous Pacemaker Lead Implantation in Patients With Univentricular Circulation and Selected Patients With Biventricular Circulation: Intracavitary and Intramyocardial Approaches"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6228-3550","authenticated-orcid":false,"given":"Katarzyna","family":"Gendera","sequence":"first","affiliation":[{"name":"TUM University Hospital, Technical University of Munich","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christof","family":"Kolb","sequence":"additional","affiliation":[{"name":"TUM University Hospital, Technical University of Munich","place":["Munich, Germany"]},{"name":"Medizinische Klinik I, Klinikum Osnabr\u00fcck","place":["Osnabr\u00fcck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4932-1150","authenticated-orcid":false,"given":"Jan","family":"Janou\u0161ek","sequence":"additional","affiliation":[{"name":"Charles University in Prague and Motol University Hospital","place":["Prague, Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6239-8160","authenticated-orcid":false,"given":"Stanimir","family":"Georgiev","sequence":"additional","affiliation":[{"name":"TUM University Hospital, Technical University of Munich","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Borgmann","sequence":"additional","affiliation":[{"name":"TUM University Hospital, Technical University of Munich","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul Philipp","family":"Heinisch","sequence":"additional","affiliation":[{"name":"TUM University Hospital, Technical University of Munich","place":["Munich, Germany"]},{"name":"University Hospital Munich, Ludwig\u2010Maximilians\u2010University","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Eicken","sequence":"additional","affiliation":[{"name":"TUM University Hospital, Technical University of Munich","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0253-1190","authenticated-orcid":false,"given":"Peter","family":"Ewert","sequence":"additional","affiliation":[{"name":"TUM University Hospital, Technical University of Munich","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2144-3775","authenticated-orcid":false,"given":"Dunja","family":"Renner","sequence":"additional","affiliation":[{"name":"TUM University Hospital, Technical University of Munich","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.15285"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrcr.2016.10.002"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.19102\/icrm.2024.15082"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.622076"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2021.06.1191"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.08.041"},{"key":"e_1_3_1_8_2","first-page":"29","article-title":"Sta\u0142a stymulacja serca u dzieci. Do\u015bwiadczenia w\u0142asne [Permanent cardiac pacing in children. Personal experience]","volume":"38","author":"Wojtalik M","year":"1993","unstructured":"Wojtalik M, Szelagowicz B, Rohde W, Sharma G. Sta\u0142a stymulacja serca u dzieci. Do\u015bwiadczenia w\u0142asne [Permanent cardiac pacing in children. Personal experience]. Kardiol Pol. 1993;38:29\u201332.","journal-title":"Kardiol Pol"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-023-03345-0"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-005-0879-6"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-021-02747-2"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2009.02365.x"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv723"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.30190"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1998.tb00156.x"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euad155"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.048577","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:41:52Z","timestamp":1789011712000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.048577"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":15,"journal-issue":{"issue":"15","published-print":{"date-parts":[[2026,8,4]]}},"alternative-id":["10.1161\/JAHA.125.048577"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.048577","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]},"assertion":[{"value":"2025-12-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e048577"}}