Permanent Pacing through a Persistent Left Superior Vena Cava: An Approach and Report of Dual-Chambered Lead Placement

Westerman, G.R.; Baker, John T.; Dungan, William T.; Devanter, Stephen H. Van

doi:10.1016/s0003-4975(10)62560-x

Cited by 13 publications

(8 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The pathological substrate of an isolated LSVC also causes dilatation of the coronary sinus, leading to stretching of the atrioventricular (AV) node and its bundle. The electrocardiogram often shows a leftward deviation of the P-wave axis and a shortened PR interval [4]. Most commonly associated malformations are atrial septal defects (16%), endocardial cushion defects (11%) and tetralogy of Fallot (9%) [5].…”

Section: Abstract • Persistent Left Superior Vena Cava (Plsvc) Ismentioning

confidence: 99%

See 1 more Smart Citation

Cardiac Defibrillator Implantation via Persistent Left Superior Vena Cava

Nakad¹,

Bayeh²,

Saleh³

2015

LMJ

View full text Add to dashboard Cite

A 62-year-old gentleman with ischemic cardiomyopathy and an ejection fraction estimated at 30% got admitted to the hospital for recurrent syncope, and was found to have non sustained ventricular tachycardia on ECG monitoring. He was referred to the electrophysiology (EP) laboratory for implantation of an implantable cardioverter defibrillator (ICD).In the EP lab, under sterile fashion, a left infraclavicular incision was made for creation of the pocket then the left subclavian vein was accessed utilizing the first rib approach. A guide wire was advanced into the vein but it took a vertical course. We confirmed that the venous system was accessed, not the subclavian artery, by examining the color and the flow of the blood. Advancing the wire further down resulted in a horizontal shape of the wire at the diaphragmatic side of the heart followed by a loop in the right lateral edge of the cardiac silhouette. The dilator was first advanced without the sheath and a venography was performed confirming the presence of a persistent left superior vena cava (PLSVC).At this point a 9 French sheath was advanced then an active fixation dual coil lead (Reliance, 0184, 59 cm, Boston Scientific, MN, USA) was inserted down the PLSVC through the coronary sinus and first parked in the right atrium.A soft stylet was shaped manually creating a large J curve. This was advanced into the lead and an extreme counterclock steering of the stylet prolapsed the lead in the right ventricle outflow tract. The stylet was then withdrawn about 1 cm and gently the whole system was pulled back. This allowed the tip of the lead to fall to a mid-septal position. Measurement of the R waves there showed amplitude of more than 12 mV so we decided to fix the lead in that position (Figure 1).The lead was secured to the muscle then connected to the generator. Defibrillation was performed at 15 joules delivered energy after induction of ventricular fibrillation 94 Nakad GF, Bayeh H, Abi Saleh B. Cardiac defibrillator implantation via persistent left superior vena cava. J Med Liban 2015 ; 63 (2) : 94-96. Nakad GF, Bayeh H, Abi Saleh B. Implantation d'un défibrillateur cardiaque interne à travers une veine cave supérieure gauche. J Med Liban 2015 ; 63 (2) : 94-96. RÉSUMÉ • La persistante de la veine cave supérieure gauche est une variante anatomique peu fréquente.Nous rapportons un cas d'implantation d'un défibrillateur cardiaque interne à travers une veine cave supérieure gauche, en prenant compte de l'aspect technique et en décrivant les implications cliniques associées à une telle procédure. ABSTRACT • Persistent left superior vena cava (PLSVC) isan uncommon anomaly. We describe a case of a left-sided implantation of an implantable cardioverter defibrillator (ICD) through a PLSVC, assessing the technical approach to such a procedure, along with a review of the clinical implications that might ensue.Learning objectives : LSVC is a rare anatomical venous variation. Knowledge of its presence and clinical implications will render a lead implantation safer and w...

show abstract

Section: Abstract • Persistent Left Superior Vena Cava (Plsvc) Ismentioning

confidence: 99%

“…Isolated cases of LSVC persistence in patients undergoing central venous line, pacemaker or cardiac defibrillator implantation have been reported in the literature [4,[6][7].…”

Section: Abstract • Persistent Left Superior Vena Cava (Plsvc) Ismentioning

confidence: 99%

Cardiac Defibrillator Implantation via Persistent Left Superior Vena Cava

Nakad¹,

Bayeh²,

Saleh³

2015

LMJ

View full text Add to dashboard Cite

show abstract

“…Bereits im frühen Embryonalstadium obliterieren die linke Kardinalvene und ihre ursprüngliche Verbindung zum linken Sinushorn, dem späteren Koronarsinus. In etwa 0,05 bis 0,5% bleibt sie jedoch offen (5,6), bei angeborenen Herzfehlern in 2-10% (10,14). Die Persistenz der linken oberen Hohlvene mit Aplasie der Vena cava superior auf der rechten Seite ist seltener (9).…”

Section: Endocardial Dual-chamber Stimulation In Persistent Left Superior Vena Cavaunclassified

Endokardiale Zwei-Kammer-Stimulation bei singulärer linkspersistierender oberer Hohlvene

He¹,

Kh²,

Hj³

2008

Dtsch med Wochenschr

View full text Add to dashboard Cite

A persistent left superior vena cava was noted in a 63-year-old woman during pacemaker implantation because of sinus bradycardia and AV dissociation. During atrial test stimulation a 2 degree AV block occurred at a rate of only 110/min and dual-chamber provision was thus necessary. Both catheters were introduced into the right heart via the coronary sinus, but placement of the right-ventricular lead was made more difficult than usual because of looping. One year later pacemaker function (DDI mode) was unchanged and the patient symptom-free.

show abstract

“…Pacientes com cardiopatia congênita que necessitem de tratamento cirúrgico podem evoluir, durante a cirurgia, com bloqueio atrioventricular total (BAVT) e necessitar de implan te de marcapasso, lembrando que para o acesso venoso existem algumas peculiaridades: a punção da veia subclávia esquerda terá mais sucesso se for realizada mais lateralmente, cuidado na inserção do dilatador e do introdutor, a fixação ativa é preferencial e o cabo-eletrodo ventricular deve ser implantado antes do atrial. Recomenda-se o implante com cabo-eletrodo de fixação ativa e na parede lateral do átrio direito 6 . Para conseguir acesso ao ventrículo direito é necessário realizar manualmente uma curva em U no guia do cabo-eletrodo ventricular, para possibilitar sua entrada pela tricúspide e fixar à ponta do ventrículo direito.…”

Section: Introductionunclassified

Radiação infravermelha e interferência no sistema de marcapasso dupla-câmara

García¹

2018

RELAMPA

View full text Add to dashboard Cite

Permanent Pacing through a Persistent Left Superior Vena Cava: An Approach and Report of Dual-Chambered Lead Placement

Cited by 13 publications

References 27 publications

Cardiac Defibrillator Implantation via Persistent Left Superior Vena Cava

Cardiac Defibrillator Implantation via Persistent Left Superior Vena Cava

Endokardiale Zwei-Kammer-Stimulation bei singulärer linkspersistierender oberer Hohlvene

Radiação infravermelha e interferência no sistema de marcapasso dupla-câmara

Contact Info

Product

Resources

About