Monomorphic Ventricular Tachycardia Secondary to an Epicardial Pacing Lead

Epicardial pacing leads are frequently used in small children and in complex congenital heart disease that precludes transvenous lead placement. While lead failure is not uncommon from epicardial pacing leads, proarrhythmic events are rare. We present an eight-year-old patient who developed spontaneous nonsustained ventricular tachycardia from a chronic unipolar epicardial pacing lead. Removal of the epicardial lead with cryoablation around the lead body resolved the ventricular tachycardia. To our knowledge, this is the first case report of a suture on epicardial pacing lead causing late ventricular tachycardia.