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Related Experiment Videos

Persistent left-sided superior vena cava--a pacing challenge.

A L Innasimuthu1, G K Rao, P Wong

  • 1Aintree Cardiac Centre, University Hospital Aintree, Liverpool, UK. antonyleslie@yahoo.co.in

Acute Cardiac Care
|November 22, 2007
PubMed
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This study details successful dual chamber pacemaker implantation in patients with a rare left sided superior vena cava (LSVC). Techniques for lead placement via subclavian veins are described for this anatomical variation.

Area of Science:

  • Cardiology
  • Medical Devices
  • Anatomy

Background:

  • Left sided superior vena cava (LSVC) is a rare congenital anomaly occurring in 0.3% of the population.
  • LSVC typically drains into the right atrium via the coronary sinus.
  • Pacemaker implantation requires careful consideration of venous anatomy.

Observation:

  • Two cases of dual chamber permanent pacemaker implantation are presented.
  • Access was gained via the left or right subclavian vein.
  • Pacing leads were advanced through the LSVC into the right atrium and ventricle.

Findings:

  • Successful lead placement was achieved in both patients with LSVC.
  • Specific techniques involving stylet shaping and fluoroscopy guided lead positioning.

Related Experiment Videos

  • Active fixation atrial leads ensured satisfactory atrial lead placement.

    • Implications:

    • Recognizing LSVC is crucial for safe transvenous lead placement, especially in emergencies.
    • Modified lead manipulation techniques are effective for pacemaker implantation in patients with LSVC.
    • Awareness of LSVC can prevent complications like cardiac perforation and tamponade.