Biventricular device implantation in a patient with congenitally corrected transposition and left-sided superior vena cava.

An increasing number of patients with congenital heart disease are surviving into adulthood and some have indications for device therapy. Complex anatomical abnormalities may hinder the operator and require the adaptation of standard implantation techniques. We present the first report of successful biventricular ICD implantation in a patient with mesocardia, congenitally corrected transposition of the great arteries, pulmonary atresia, and a left superior vena cava draining into the coronary sinus. This case posed challenges in lead placement due to both complex anatomy and the risk of inappropriate device therapies secondary to far-field oversensing.