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A 62-year-old woman was referred for upgrade of her single chamber AAIR pacemaker to dual chamber due to symptomatic bradycardia with high-grade AV block. She previously underwent mechanical aortic, mitral, and tricuspid valve replacement due to rheumatic heart disease. Subsequently, she developed sick sinus syndrome and a single chamber pacemaker (AAIR) was implanted. No ventricular leads were placed at that time due to the …

Transvenous left ventricular lead placement in a patient with mechanical tricuspid, aortic, and mitral valves