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Translational Rabbit Model of Chronic Cardiac Pacing

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A case of difficult temporary pacing.

Goutam Datta¹, Biswakesh Majumder, Avijit Bannerjee

¹Department of Cardiology, Institute of Post Graduate Medical Education and Research, West Bengal, Calcutta, India. goutamdattadn@yahoo.in

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology

|February 5, 2011

Summary

This summary is machine-generated.

A patient with complete heart block experienced syncope. A unique venous anomaly prevented standard pacing lead placement, requiring an alternative azygos vein approach for successful temporary cardiac pacing.

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Area of Science:

Cardiology
Vascular Anatomy
Electrophysiology

Background:

Complete heart block can cause syncope, necessitating temporary cardiac pacing.
Standard transvenous lead placement relies on the inferior vena cava (IVC) connecting to the right atrium.

Observation:

A 55-year-old female presented with recurrent syncope due to complete heart block.
Attempted temporary pacing lead insertion via the IVC failed due to an anomalous venous connection.
A venogram revealed the IVC was not connected to the right atrium.

Findings:

An unusual venous anomaly was identified, presenting a challenge for cardiac pacing.
Successful temporary pacing lead placement was achieved by navigating the azygos vein and superior vena cava to the right atrium and ventricle.
The patient had no history of congenital heart disease or visceral heterotaxy, making the anomaly's origin unclear.

Implications:

This case highlights the importance of recognizing rare venous anomalies in cardiac procedures.
An alternative approach using the azygos vein is feasible for temporary cardiac pacing in complex venous anatomies.
Understanding such anomalies is crucial for successful interventional cardiology and electrophysiology procedures.