Intractable interference between epicardial and transvenous pacemakers induced by radiofrequency catheter ablation

Patients with congenital heart disease (CHD) who undergo open-heart surgery are often treated with epicardial pacemakers (Epi-PMs) to manage postoperative bradyarrhythmias. The transition to a transvenous pacing system (TV-PM) may become necessary because of epicardial lead failure or the need to switch from single-chamber to dual-chamber pacing. In some cases, the epicardial system is retained as a backup. Although abandoned pacemakers often experience battery depletion without any clinical consequences, complications can arise when an Epi-PM enters the end-of-service (EOS) phase.