Fontan-related morbidity and paced QRS duration: A case series

Permanent pacemakers have been associated with Fontan-related morbidity and mortality. Longer QRS duration and QRS prolongation over time may be associated with poorer outcomes in Fontans patients. We present a series of eleven Fontan patients with ventricular pacing on serial electrocardiograms (ECGs), including seven with Fontan-related morbidity. Paced QRS duration increased over time in nearly all patients, with several having extremely long QRS durations at the end of the follow-up period. We explore the role that paced QRS duration may play in Fontan-related morbidity and mortality and its potential as a therapeutic target for patient management.