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Implantation of transvenous permanent pacemaker in a patient with persistent left superior vena cava and absent right superior vena cava.

Alemzadeh-Ansari MJ, Shafiee A, Yaminisharif A - Int Cardiovasc Res J (2013)

Bottom Line: Vascular access has remained a major challenge for implantation of permanent pacemaker leads.A persistent Left Superior Vena Cava (LSVC), especially with an absent Right Superior Vena Cava (RSVC), is a rare finding during pacemaker implantation and is accompanied by technical difficulties.The patient had a persistent LSVC with an absent RSVC.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran.

ABSTRACT
Vascular access has remained a major challenge for implantation of permanent pacemaker leads. A persistent Left Superior Vena Cava (LSVC), especially with an absent Right Superior Vena Cava (RSVC), is a rare finding during pacemaker implantation and is accompanied by technical difficulties. Herein, we describe a case of sinoatrial node arrest, in which finding a suitable vein for passing the lead was challenging. The patient had a persistent LSVC with an absent RSVC.

No MeSH data available.


Related in: MedlinePlus

The Right Atrium and Right Ventricle Leads Implantation Was Performed via the Persistent Left Superior Vena Cava.
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fig8303: The Right Atrium and Right Ventricle Leads Implantation Was Performed via the Persistent Left Superior Vena Cava.

Mentions: The approach via the left subclavian vein for the implantation of the pacemaker leads resulted in an unexpected entrance into the right atrium through the coronary sinus vein. Venography from the left subclavian vein revealed that the dye drained into the right atrium through an LSVC and the coronary sinus vein (Figure 2A). Consequently, we decided to implant the pacemaker leads through the right subclavian vein. Interestingly, the dye drained into the LSVC via the innominate vein in the venography of the right subclavian vein and revealed the absence of the RSVC (Figure 2B). At this point, we decided to approach via the left subclavian for the lead implantation. A 58-cm Medtronic 5076 CapSureFix Novus lead (Medtronic, Inc., Minneapolis, MN, USA) was placed in the right atrium and an LV pacing lead with an over-the-wire technique (EASYTRAK model 4518, Guidant Corp, St. Paul, Minnesota) was positioned in the right ventricle using the loop technique (Figure 3). Attempts to implant the LV lead in one of the coronary sinus branches were not successful. The leads were thereafter connected to the VEDR01 Versa DR generator (Medtronic, Minneapolis, USA) in the DDDR mode. The patient was discharged in a good condition and the 1-year follow-up was eventless. The pacemaker was working properly with acceptable pacing and sensing in both atrial and ventricular leads (V- pacing = 0.5 V, pulse width = 0.46 ms).


Implantation of transvenous permanent pacemaker in a patient with persistent left superior vena cava and absent right superior vena cava.

Alemzadeh-Ansari MJ, Shafiee A, Yaminisharif A - Int Cardiovasc Res J (2013)

The Right Atrium and Right Ventricle Leads Implantation Was Performed via the Persistent Left Superior Vena Cava.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3987451&req=5

fig8303: The Right Atrium and Right Ventricle Leads Implantation Was Performed via the Persistent Left Superior Vena Cava.
Mentions: The approach via the left subclavian vein for the implantation of the pacemaker leads resulted in an unexpected entrance into the right atrium through the coronary sinus vein. Venography from the left subclavian vein revealed that the dye drained into the right atrium through an LSVC and the coronary sinus vein (Figure 2A). Consequently, we decided to implant the pacemaker leads through the right subclavian vein. Interestingly, the dye drained into the LSVC via the innominate vein in the venography of the right subclavian vein and revealed the absence of the RSVC (Figure 2B). At this point, we decided to approach via the left subclavian for the lead implantation. A 58-cm Medtronic 5076 CapSureFix Novus lead (Medtronic, Inc., Minneapolis, MN, USA) was placed in the right atrium and an LV pacing lead with an over-the-wire technique (EASYTRAK model 4518, Guidant Corp, St. Paul, Minnesota) was positioned in the right ventricle using the loop technique (Figure 3). Attempts to implant the LV lead in one of the coronary sinus branches were not successful. The leads were thereafter connected to the VEDR01 Versa DR generator (Medtronic, Minneapolis, USA) in the DDDR mode. The patient was discharged in a good condition and the 1-year follow-up was eventless. The pacemaker was working properly with acceptable pacing and sensing in both atrial and ventricular leads (V- pacing = 0.5 V, pulse width = 0.46 ms).

Bottom Line: Vascular access has remained a major challenge for implantation of permanent pacemaker leads.A persistent Left Superior Vena Cava (LSVC), especially with an absent Right Superior Vena Cava (RSVC), is a rare finding during pacemaker implantation and is accompanied by technical difficulties.The patient had a persistent LSVC with an absent RSVC.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran.

ABSTRACT
Vascular access has remained a major challenge for implantation of permanent pacemaker leads. A persistent Left Superior Vena Cava (LSVC), especially with an absent Right Superior Vena Cava (RSVC), is a rare finding during pacemaker implantation and is accompanied by technical difficulties. Herein, we describe a case of sinoatrial node arrest, in which finding a suitable vein for passing the lead was challenging. The patient had a persistent LSVC with an absent RSVC.

No MeSH data available.


Related in: MedlinePlus