Successful implantable cardioverter‐defibrillator implantation through a communicating branch of the persistent left superior vena cava

Kumar, Vineet; Yoshida, Naoki; Yamada, Takumi

doi:10.1016/j.joa.2015.01.005

Cited by 6 publications

(6 citation statements)

References 4 publications

(5 reference statements)

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“…Transvenous leads entering the RA via the PLSVC and CS are directed posteriorly away from the tricuspid annulus, making it difficult to direct a lead across the TV annulus into the RV. There are several approaches that can be utilized for left-sided RV lead placement: (1) implantation via the communicating vein, 5 , 6 which was absent in our case; (2) use of J-tipped or manually shaped stylets with large curves, 3 , 9 although this technique can be particularly challenging with ICD leads compared to pacemaker leads and was unsuccessful in this particular case; and (3) use of a CS delivery sheath, which can be used to direct leads toward the RV. 10 , 11 While CS delivery sheaths from most vendors can be used for pacemaker lead implantation, larger-diameter sheaths for ICDs are not routinely available.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Previously reported techniques for delivering left-sided leads into the right ventricle (RV) involved specially curved stylets or use of a communicating branch of the PLSVC. 2 , 3 , 4 , 5 , 6 , 7 As opposed to pacemaker leads, stylets are not as effective for redirecting ICD leads from the CS ostium toward the tricuspid annulus. In the absence of a communicating vein between the right-sided superior vena cava and PLSVC, right-sided implant may be required that is associated with higher defibrillation threshold (DFT).…”

Section: Introductionmentioning

confidence: 99%

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Transfemoral snare–assisted placement of a left-sided defibrillator lead in the presence of a persistent left superior vena cava

Ali

Mohammed

et al. 2021

HeartRhythm Case Reports

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show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transfemoral snare–assisted placement of a left-sided defibrillator lead in the presence of a persistent left superior vena cava

Ali

Mohammed

et al. 2021

HeartRhythm Case Reports

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show abstract

“…Furthermore, this patient may need an upgrade from an ICD to a cardiac resynchronization therapy device in the near future because of the presence of cardiomyopathy, but a left ventricular (LV) lead implantation via a PLSVC seems difficult. A recent paper has demonstrated both successful ICD [12] and LV [13] , [14] lead implantation through a small branch communicating between a PLSVC and the right-sided venous drainage. However, as in our case, the PLSVC and right superior vena cava are not connected by a communicating branch in 40% of cases ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Successful dual chamber ICD implantation via a persistent left superior vena cava after ratchet syndrome

Anjo

Kamijima

Hori

et al. 2016

Journal of Arrhythmia

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“…PLSVC is a vascular anomaly and can be incidentally detected during right heart invasive procedures. However, PLSVC may cause technical difficulties during cardiac device implantation ( 2 ). The presence of a dilated CS should alter the medical team to the possibility of a PLSVC.…”

Section: Discussionmentioning

confidence: 99%

A complicated trilogy: persistent left superior vena cava with hypertrophic cardiomyopathy and atrial septal defect

2016

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A 28-year-old asymptomatic woman was referred to our clinic for evaluation of a heart murmur. Transthoracic echocardiography (TTE) demonstrated ventricular hypertrophy with septal thickness of 26 mm, consistent with hypertrophic cardiomyopathy (HCM) (Fig. 1A). The diagnosis of HCM was confirmed by contrast-enhanced magnetic resonance imaging, and late gadolinium enhancement was observed in the anterior wall (Fig. 1B and C). The patient’s coronary sinus (CS) was dilated and, therefore, underwent contrast echocardiography with a prediagnosis of persistent left superior vena cava (PLSVC) (Fig. 1A and D). Saline was administered through a left brachial vein, and the CS opacified first followed by the right atrium (Fig. 1E and Video 1). After saline was administered through the patient’s right arm, her right atrium opacified before the CS. She was diagnosed with PLSVC. TTE revealed a secundum atrial septal defect (ASD), and Doppler echocardiography confirmed a leftto-right shunt (Fig. 1F and Video 2). Although the Qp:Qs ratio was <1.5, valvular function, right heart volume and systolic pulmonary arterial pressure were normal. She was included in a follow-up program. PLSVC, HCM and ASD are common congenital heart diseases; however, they are rarely observed together. The risk of arrhythmia and sudden cardiac death is increased in HCM (1). An implantable cardioverter defibrillator is the only therapy in this clinical setting. PLSVC is a vascular anomaly and can be incidentally detected during right heart invasive procedures. However, PLSVC may cause technical difficulties during cardiac device implantation (2). The presence of a dilated CS should alter the medical team to the possibility of a PLSVC. We suggest that contrast echocardiography with agitated saline injected intravenously through the left arm is an important and useful technique in the diagnosis of PLSVC. To the best of our knowledge, our report is the first in the literature of a patient with PLSVC with HCM and ASD together.

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Successful implantable cardioverter‐defibrillator implantation through a communicating branch of the persistent left superior vena cava

Cited by 6 publications

References 4 publications

Transfemoral snare–assisted placement of a left-sided defibrillator lead in the presence of a persistent left superior vena cava

Transfemoral snare–assisted placement of a left-sided defibrillator lead in the presence of a persistent left superior vena cava

Successful dual chamber ICD implantation via a persistent left superior vena cava after ratchet syndrome

A complicated trilogy: persistent left superior vena cava with hypertrophic cardiomyopathy and atrial septal defect

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