Right Ventricular Electrode Lead Implantation via a Persistent Left Superior Vena Cava

Hsiao, Hsiang Chiang; Kong, Chi Woon; Wang, Jiann Jong; Chan, Wan Leong; Wang, Shin Pu; Chang, Mau Song; Chiang, Benjamin N.

doi:10.1177/000331979704801010

Cited by 14 publications

(6 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In these cases Boston and St Jude stylets were used. It needs little manipulation since it only has to be given a slight clockwise or anticlockwise rotation on withdrawing the stylet, has a high success rate (100% in our series) and is accompanied by less fluoroscope time and procedure than other series [1] and case reports [21-23] in the pertinent literature. Electrode dysfunction has not been found in patient follow-ups.…”

Section: Discussionmentioning

confidence: 88%

See 1 more Smart Citation

A Novel Method of Placing Right Ventricular Leads in Patients With Persistent Left Superior Vena Cava Using a Conventional J Stylet

Mora

2014

Indian Pacing and Electrophysiology Journal

View full text Add to dashboard Cite

BackgroundLocating pacemaker electrodes can become complicated by congenital abnormalities such as persistent left superior vena cava (LSVC).ObjectiveTo evaluate a technique for the implanting of ventricular electrode in patients with persistent LSVC.Materials and Methods The study was carried out from June 2001 to June 2010 involving all patients who were admitted to the Hospital Universitario Mayor, Instituto de Corazon de Bogota and Hospital Universitario Clinica San Rafael (Bogota-Colombia) for implanting pacemakers or cardiac defibrillators. LSVC was diagnosed by fluoroscopic observation (anterior-posterior view) of the course of the stylet. Four steps were followed: 1) Move the electrode with a straight stylet to the right atrium. 2) Change the straight stylet by a conventional J stylet and push the electrode to the lateral or anterolateral wall of the right atrium. 3) Remove the guide 3-5 cm and 4) Push the electrode which crosses the tricuspid valve into the right ventricle and finally deploy the active fixation mechanism.ResultsA total of 1198 patients were admitted for pacemaker or cardiac defibrillator implant during the 9-year study period, 1114 received a left subclavian venous approach. There were 573 males and 541 females. Persistent LSVC was found in five patients (0.45%) Fluoroscopy time for implanting the ventricular electrode ranged from 60 to 250 seconds, 40 to 92 minutes being taken to complete the whole procedure.ConclusionWe present a simple and rapid technique for electrode placement in patients with LSVC using usual J guide and active fixation electrodes with high success.

show abstract

Section: Discussionmentioning

confidence: 88%

“…Approaches such as curving the stylet into a pigtail [22], using an L-shaped lead [14] or a wide loop have been described [23]. Dirix et al [24] used a pre-shaped J-lead, after manipulation in a posteroanterior plane, the tricuspid valve could easily be passed.…”

Section: Discussionmentioning

confidence: 99%

A Novel Method of Placing Right Ventricular Leads in Patients With Persistent Left Superior Vena Cava Using a Conventional J Stylet

Mora

2014

Indian Pacing and Electrophysiology Journal

View full text Add to dashboard Cite

show abstract

“…[ 10 ] During leads placement for a permanent pacemaker in such cases, the left subclavian vein is the preferred route. There is an acute angle between the CS ostium and the tricuspid valve; therefore, the lead should be looped in the RA to enter the right ventricle[ 11 ] Cardiac surgeries involving cannulation of SVC for cardiopulmonary bypass require isolated LSVC cannulation whenever it is detected. However, it does not allow the use of retrograde cardioplegia as it may be ineffective.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Isolated persistent left superior vena cava: A case report and its clinical implications

et al. 2017

View full text Add to dashboard Cite

The venous anomaly of a persistent left superior vena cava (PLSVC) affects 0.3%–0.5% of the general population. PLSVC with absent right superior vena cava, also termed as “isolated PLSVC,” is an extremely rare venous anomaly. Almost half of the patients with isolated PLSVC have cardiac anomalies in the form of atrial septal defect, endocardial cushion defects, or tetralogy of Fallot. Isolated PLSVC is usually innocuous. Its discovery, however, has important clinical implications. It can pose clinical difficulties with central venous access, cardiothoracic surgeries, and pacemaker implantation. When it drains to the left atrium, it may create a right to left shunt. In this case report, we present the incidental finding of isolated PLSVC in a patient who underwent aortic valve replacement. Awareness about this condition and its variations is important to avoid complications.

show abstract

“…In some patients, the endocardial approach seems impossible and sometimes epicardial pacing is necessary. To overcome this problem, various techniques using custom- or ready-made stylets or a coronary sinus (CS) cannulation sheath have been described in the literature [[1], [2], [3], [4], [5], [6]]. However, they heavily depend on the operator's skill or experience, so that they can often be time-consuming, which may increase radiation exposure.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of a lead delivery system consisting of a fixed-shaped sheath and a lumenless bipolar lead in a patient with absent right and persistent left superior vena cava: A case report

Sasaki

Tateishi

Sawada

2018

Indian Pacing and Electrophysiology Journal

View full text Add to dashboard Cite

We report the case of an 84-year-old female with symptomatic bradycardia due to a complete atrioventricular block, who carried absent right and persistent left superior vena cava (SVC). Implantation of a pacing lead, particularly within the right ventricle (RV) in a patient with this venous anomaly is accompanied by technical difficulties. However, the apparatus consisting of a fixed-curve sheath (Model C315-S10, Medtronic, Inc., Minneapolis, MN, USA) and a lumenless fixed-screw pacing lead (Model 3830, Medtronic), allowed a rapid delivery into the RV without any complications. By rotating the Model C315-S10 sheath in the counterclockwise direction in the right atrium, its tip faced the tricuspid orifice, advanced across the tricuspid valve and confronted the RV lower septum near the apex. Then the RV-lead was fixed with acceptable pacing and sensing parameters. Utilizing a lumenless pacing lead and a preformed sheath to deliver it is a novel approach that could be helpful in pacemaker implantation in patients with absent right and persistent left SVC.

show abstract

Right Ventricular Electrode Lead Implantation via a Persistent Left Superior Vena Cava

Cited by 14 publications

References 19 publications

A Novel Method of Placing Right Ventricular Leads in Patients With Persistent Left Superior Vena Cava Using a Conventional J Stylet

A Novel Method of Placing Right Ventricular Leads in Patients With Persistent Left Superior Vena Cava Using a Conventional J Stylet

Isolated persistent left superior vena cava: A case report and its clinical implications

Usefulness of a lead delivery system consisting of a fixed-shaped sheath and a lumenless bipolar lead in a patient with absent right and persistent left superior vena cava: A case report

Contact Info

Product

Resources

About