Implantation of a dual chamber pacemaker in a patient with persistent left superior vena cava

doi:10.1016/0167-5273(92)90017-W

International Journal of Cardiology

Volume 36, Issue 2, August 1992, Pages 242-243

https://doi.org/10.1016/0167-5273(92)90017-W Get rights and content

Abstract

A patient underwent dual chamber pacemaker implantation by puncture of the left subclavian vein. During the procedure we observed persistence of the left superior vena cava. An active fixation atrial lead was required to prevent instability induced by the odd course of the electrode and produced excellent long term pacing and sensing.

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There are more references available in the full text version of this article.

Cited by (24)

Implantation of a single coil ICD via persistent left superior vena cava
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A challenging dual chamber permanent pacemaker implantation in persistent left superior vena cava with absent right superior vena cava
2012, Journal of Cardiology Cases
Citation Excerpt :
It seems to be very difficult to place a regular atrial lead because of its shape. Several authors have reported use of active fixation lead in this situation [11,12]. But the use of an active fixation lead is not always without danger [13].
An isolated persistent left superior vena cava (PLSVC) with absent right superior vena cava is a rare and generally asymptomatic congenital malformation. It is usually discovered incidentally during a pacemaker implantation or electrophysiological procedures. We report an adult male who underwent successful dual chamber permanent pacemaker implantation through left subclavian approach with a 7-year follow-up showing a still appropriate function of the device. We discuss the technical issues and solutions to overcome such technical difficulties.
An alternative technique for implantation of a dual chamber pacemaker via a persistent left superior vena cava using a coronary sinus guiding catheter
2010, Journal of Cardiology Cases
Citation Excerpt :
However, as in this case, it may come to light during diagnostic or therapeutic procedures with an unusual early inferior course of a guidewire passed through the left subclavian vein and allowing the diagnosis to be confirmed with contrast venography. Lead insertion is usually possible on the left side but can be complex, time consuming and involve prolonged radiation exposure [6–8]. When the right superior vena cava or innominate vein is also absent this presents an additional challenge.
Persistence of left superior vena cava, absence of coronary sinus and cerebral ictus
2008, International Journal of Cardiology
Citation Excerpt :
Clinical complications of this anomaly are cyanosis and reduced strain tolerance. Persistence of LSVC takes on more importance in the event of cardiovascular surgery (absolute contraindication in retrograde cardioplegia) [6,10], central venous and permanent transvenous pacing lead placement, [11–14]. In our report, as in others cases in the literature, the diagnosis of persistence of LSVC was found occasionally.
Persistent left superior vena cava: Case reports and clinical implications
2006, International Journal of Cardiology
We report four cases of persistent left superior vena cava (LSVC) incidentally recognized during device implantation. Persistent LSVC is the commonest venous anomaly of the thorax and drains into the right atrium via the coronary sinus. Persistent LSVC demonstrates several congenital variations including variable communication with right-sided superior vena cava (SVC), absence of right-sided SVC, drainage into the left atrium creating a right to left shunt, and association with other congenital anomalies of the heart and great vessels. Abnormal persistent fetal dispersion of specialized pacemaker and conduction tissue, which occurs in some individuals with persistent LSVC, may provide an arrhythmogenic substrate. In this article we discuss embryology, diagnostic approaches, clinical features, technical difficulties in accessing the right ventricle, and a review of literature related to persistent LSVC.
Chest X-ray and electrocardiographic abnormality after permanent pacemaker insertion
1994, The American Journal of Cardiology
An 80-year-old man with past evidence of myocardial ischemia, peripheral vascular disease and atrial fibrillation was admitted for a clotted left lower extremity vascular graft. Four months earlier, he had a permanent pacemaker inserted for acquired complete heart block. The chest x-ray and 12-lead electrocardiogram obtained are shown in Figures 1 and 2.
The patient had a persistent left superior vena cava (SVC). The chest x-ray showed pacemaker wires entering the right atrium through the persistent left SVC and not the common SVC as expected. The electrocardiogram showed a right bundle branch block, which is unusual as the ventricular lead of the pacemaker is in the right ventricular apex. This right bundle branch block pattern in the electrocardiogram occurred because of a preexisting right bundle branch block (Figure 3) and not as a result of the persistent left SVC.

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Brief reportImplantation of a dual chamber pacemaker in a patient with persistent left superior vena cava

Abstract

Am Heart J

Long term transvenous ventricular pacing in adults with congenital abnormalities of the heart and great arteries

Br Heart J

Brief report
Implantation of a dual chamber pacemaker in a patient with persistent left superior vena cava