DUAL CHAMBER PACING VIA A PERSISTENT LEFT-SIDED SUPERIOR VENA CAVA

Abstract

Congenital anomalies of superior vena cava (SVC) can complicate the placement of ‎transvenous pacemaker leads. Persistent left SVC (PLSVC) is the most common ‎congenital anomaly of SVC. In this paper, we describe the case of a 72-year-old male ‎patient who presented with complete heart block and PLSVC. The anomaly was ‎verified by venography. Atrial (passive fixation) and ventricular (screw-in) leads were ‎passed down the PLSVC and coronary sinus (CS) and the tips were positioned in the ‎right atrial appendage and right ventricular apex, respectively. Follow-up of the ‎patient revealed good pacing and sensing thresholds with stable lead positions. ‎Venography and long, active fixation leads can help overcome the technical problems ‎of PPM implantation in these patients (Iranian Heart Journal 2003; 4 (2,3): 80-81).‎