Permanent cardiac pacing in a patient with persistent left superior vena cava and concomitant agenesis of the right‐sided superior vena cava

Hassine, Majed; Hamdi, Sonia; Chniti, Ghassen; Boussaada, M.; Bouchehda, Nidhal; Mahjoub, M.; Hamda, Khaldoun Ben; Betbout, Fethi; Maatouk, Faouzi; Gamra, Habib

doi:10.1016/j.joa.2015.03.008

Cited by 9 publications

(6 citation statements)

References 3 publications

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“…The coronary sinus (CS) may be dilated, which render pacing leads positioning from the left subclavian region difficult, especially the ventricular lead. The literature regarding PPI in patients with PLSVC is sparse and limited to a few case reports [2–8]. The use of active fixation leads with special curved stylet may help in overcoming this technical difficulty [2].…”

Section: Introductionmentioning

confidence: 99%

Transvenous dual-chamber pacemaker implantation in patients with persistent left superior vena cava

Liao

et al. 2019

BMC Cardiovasc Disord

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Background Persistent left superior vena cava (PLSVC) is a rare congenital vascular anomaly. Permanent pacemaker implantation (PPI) in patients with PLSVC can be challenging because of the venous anomalies. We reported a case series of patients with PLSVC who underwent PPI with double active fixation leads. Methods From January 2012 to July 2016, 9 patients (three male and six females, mean age 68 ± 11 years) with PLSVC who received a dual-chamber pacemaker with double active fixation leads were enrolled retrospectively in this observational study. The indications for pacemaker implantation were symptomatic third-degree atrioventricular block in one and sick sinus syndrome in eight patients. Results PPI were implanted successfully in all 9 patients. Successful positioning of the ventricular leads at the right ventricular outflow tract (RVOT) septum with a “C” shaped stylet was achieved in 7 patients (77.8%). In the remaining two cases, the ventricular leads were placed in the right ventricular apex and the inferior free wall of the sub-tricuspid annulus. The atrial leads were placed at the lateral wall of the right atrium in all patients. Procedure time and fluoroscopy time were 85.3 ± 11.3 min and 4.5 ± 1.1 min respectively. During a mean follow-up of 4 years, no complications were observed and pacing parameters did not change significantly. Conclusion PPI through PLSVC may be technically feasible, safe, and effective. Double active fixation leads may be standard for patients with PLSVC and most of the ventricular leads could be placed at the RVOT septum.

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Section: Introductionmentioning

confidence: 99%

Transvenous dual-chamber pacemaker implantation in patients with persistent left superior vena cava

Liao

et al. 2019

BMC Cardiovasc Disord

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“…5,6 The operator should be aware of anatomical abnormalities, difficulties in electrochemical fixation, and potential procedural complications; in case of LSVC without SVC, it is more difficult to insert the lead in the CS. 7 It is important to perform a venous angiography to identify LVSC, to evaluate the angle of the CS orifice and the possible presence of a double vena cava. 8 To insert the lead into the CS, it may be useful to use guides with atypical curves.…”

Section: Discussionmentioning

confidence: 99%

“…The operator should be aware of anatomical abnormalities, difficulties in electrochemical fixation, and potential procedural complications; in case of LSVC without SVC, it is more difficult to insert the lead in the CS 7 …”

Section: Discussionmentioning

confidence: 99%

Active fixation coronary sinus lead in a patient with persistence of left superior vena cava

Caravati

Golino

et al. 2020

Clinical Case Reports

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“…Because of the lack of hemodynamic abnormalities, it is almost always detected during invasive surgeries or during imaging. 4,5 In this report, we summarized six cases of PLSVC that were accidentally diagnosed during the insertion of peripherally inserted central catheter (PICC) or a port at the Venous Access Center (VAC) of our hospital from 2019 to 2020.…”

Section: Introductionmentioning

confidence: 99%

Analysis of six cancer patients with persistent left superior vena cava identified during central venous access device placement via an intracavitary electrocardiogram

et al. 2021

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Persistent left superior vena cava (PLSVC) is a rare congenital anomaly. PLSVC can be associated with clinically significant atrial septal defect (ASD) or ventricular septal defect (VSD). It is usually asymptomatic and accidentally detected during invasive procedures or imaging examinations. However, whether central venous access device (CVAD) can be placed and used in patients with PLSVC is controversial. A total of six patients were diagnosed with PLSVC and confirmed by chest CT among 3391 cancer patients who underwent CVAD placement via intracavitary electrocardiogram (IC-EKG) at the Venous Access Center (VAC) from May 2019 to December 2020. The CVADs (peripherally inserted central catheter in four patients and Ports in two patients) of these six patients were left in PLSVC. We analyzed changes in the P-wave in the IC-EKG during CVAD placement and the characteristics of the body surface electrocardiogram in these patients and discussed the catheter tip position in PLSVC. All six patients showed negative P-waves in lead II via IC-EKG from the beginning of catheterization: four patients showed negative P-waves and two showed biphasic P-waves in the body surface electrocardiogram (lead III) before catheterization. CVAD function was normal and no obvious complications were observed during the treatment of these patients. The total retention time of CVADs was 1537 days. For patients with a negative P-wave in lead II via IC-EKG during catheterization, especially in those with a negative or biphasic P-wave in lead III of the body surface electrocardiogram, PLSVC should be considered. CVAD insertion in patients with type I PLSVC is safe under certain conditions, with the proper tip position in the middle to lower part of PLSVC.

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Permanent cardiac pacing in a patient with persistent left superior vena cava and concomitant agenesis of the right‐sided superior vena cava

Cited by 9 publications

References 3 publications

Transvenous dual-chamber pacemaker implantation in patients with persistent left superior vena cava

Transvenous dual-chamber pacemaker implantation in patients with persistent left superior vena cava

Active fixation coronary sinus lead in a patient with persistence of left superior vena cava

Analysis of six cancer patients with persistent left superior vena cava identified during central venous access device placement via an intracavitary electrocardiogram

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