Abstract
Current technology permits uncomplicated implantation of a functioning coronary sinus lead in the vast majority of patients with normal cardiac anatomy. However, patients with congenital heart disease present a particular challenge. In patients with situs inversus and dextrocardia, implantation of the endocardial leads in a mirror-image orientation to that used in levocardia is facilitated by mirror-image fluoroscopic angles. This technique cannot be applied to patients with dextrocardia and dextrorotation but without situs inversus, in whom the unconventional position of commonly used anatomic landmarks makes the procedures more difficult.
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