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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
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Related Experiment Video

Updated: May 7, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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Persistent left superior vena cava and pacemaker implantation.

Daniele Pontillo1, Nicolino Patruno

  • 1Daniele Pontillo, Division of Cardiology, Complesso Ospedaliero Belcolle, Padiglione di Montefiascone, Montefiascone (VT), 01027, Italy.

World Journal of Cardiology
|October 11, 2013
PubMed
Summary

Persistent left superior vena cava is a common anomaly impacting pacemaker lead implantation. Transthoracic ultrasound is recommended for preoperative diagnosis to ensure safe lead placement and avoid coronary sinus approaches.

Keywords:
Cardiovascular anatomyCoronary sinusEchocardiographyPacemaker implantationPersistent superior vena cava

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly.
  • PLSVC can complicate pacemaker and implantable cardioverter-defibrillator lead implantation.
  • Accurate identification of PLSVC is crucial for procedural success and patient safety.

Purpose of the Study:

  • To highlight the challenges of pacemaker lead implantation in patients with PLSVC.
  • To discuss the importance of preoperative diagnosis of venous anomalies.
  • To recommend a safe and effective diagnostic approach for PLSVC.

Main Methods:

  • Review of clinical cases and relevant literature concerning PLSVC.
  • Discussion of potential complications during lead implantation.
  • Emphasis on preoperative diagnostic workup.

Main Results:

  • PLSVC presents unique challenges for lead placement, especially if the right superior vena cava is absent.
  • Coronary sinus lead implantation is associated with safety concerns in the presence of PLSVC.
  • Transthoracic ultrasound is an effective method for identifying PLSVC.

Conclusions:

  • Preoperative diagnosis of PLSVC is essential for planning safe lead implantation.
  • Transthoracic ultrasound offers a straightforward and reliable method for identifying PLSVC.
  • Avoiding coronary sinus approaches is advised for defibrillator lead implantation in PLSVC patients.