Sinus node dysfunction is a common problem and adversely impacts patients who have undergone the Fontan operation. In Fontan patients with an adequate junctional escape rhythm, the benefit of atrial pacing to restore atrioventricular synchrony remains unclear. Data were collected retrospectively on all Fontan patients with junctional rhythm who underwent atrial pacing during cardiac catheterization. Hemodynamics were obtained at baseline and after atrial pacing for 5–10 min. Seven patients, mean age 10 years (3–21) were studied. The type of Fontan was extracardiac in 6 and lateral tunnel in one. Patients were paced at 10 bpm faster than their junctional rate. With pacing, there was a significant decrease in left atrial pressure from (mean ± SEM) 8.8 ± 2.6 to 5.5 ± 2.9 mmHg (p = 0.02), a significant increase in cardiac index from 2.7 ± 0.8 to 3.5 ± 1 L/min/m² (p = 0.01) and pulmonary blood flow from 2.1 ± 0.6 to 2.7 ± 0.7 L/min/m² (p = 0.001), and no significant change in pulmonary artery pressure, from 13.4 ± 2.8 to 12.4 mmHg ± 3.6 (p = 0.06) or pulmonary vascular resistance from 2.1 ± 0.86 to 3.25 ± 1.9 WU × M2 (p = 0.1). In Fontan patients with junctional rhythm, atrial pacing decreased the left atrial pressure, increased cardiac output and did not significantly change the pulmonary artery pressure. Our study supports further investigation into the utility of prophylactic atrial pacemaker implantation in Fontan patients with significant durations of JR on ambulatory monitoring.

窦房结功能障碍是一个常见问题，会对接受 Fontan 手术的患者产生不利影响。在具有足够交界性逃逸节律的 Fontan 患者中，心房起搏对恢复房室同步性的益处仍不清楚。回顾性收集了在心导管插入术期间接受心房起搏的所有交界性心律的 Fontan 患者的数据。在基线和心房起搏 5-10 分钟后获得血流动力学。研究了 7 名患者，平均年龄 10 岁（3-21 岁）。Fontan类型为心外型6例，侧隧道型1例。患者的起搏速度比他们的交界速度快 10 bpm。起搏后，左心房压力显着降低，从（平均值 ± SEM）8.8 ± 2.6 降至 5.5 ± 2.9 mmHg（p = 0.02)，心脏指数从 2.7 ± 0.8 显着增加至 3.5 ± 1 L/min/m ² ( p  = 0.01)，肺血流量从 2.1 ± 0.6 显着增加至 2.7 ± 0.7 L/min/m ² ( p  = 0.001)，肺动脉压没有显着变化，从 13.4 ± 2.8 到 12.4 mmHg ± 3.6 ( p  = 0.06) 或肺血管阻力从 2.1 ± 0.86 到 3.25 ± 1.9 WU × M2 ( p = 0.1)。在交界性节律的 Fontan 患者中，心房起搏降低了左心房压力，增加了心输出量，并且没有显着改变肺动脉压力。我们的研究支持进一步研究预防性心房起搏器植入在动态监测中具有显着 JR 持续时间的 Fontan 患者的效用。