Old but not forgotten: Creative use of abandoned epicardial leads after more than 2 decades

Introduction There are currently more than 2.4 million children, adolescents, and adults living in the United States with congenital heart disease (CHD), and nearly 300,000 of these individuals have severe CHD. As the prevalence of CHD continues to increase, pediatric and adult congenital cardiologists are continually faced with new challenges in caring for this unique patient population. One such challenge is the management of arrhythmias, especially in adults with complex access issues. Given the complex anatomic nature of severe CHD mitigated by prior surgical correction, standard pacing techniques and lead placement approaches are at times impractical or impossible to attain. In this case series, we detail 3 novel cases in adults with CHD in which previously abandoned epicardial leads proved useful decades after initial lead placement, during events when standard pacing options were not otherwise possible.