Pacemaker implantation in persistent left superior venacava with absent right superior venacava: Lessons learnt

Publication date: March 2018Source: Journal of Indian College of Cardiology, Volume 8, Issue 1Author(s): Shreetal Rajan Nair, C.G. SajeevAbstractA 55 year old male presented to us with history of recurrent episodes of syncope following which he was detected to have sick sinus syndrome and was planned for a permanent pacemaker implantation. During the procedure he was incidentally detected to have a persistent left superior venacava with absent right superior venacava as probably his initial echocardiogram was overlooked and the procedure was replanned to a later date. A 64 slice MDCT scan was done to delineate the venacaval and great arterial relationship which confirmed a persistent left superior venacava with absent right superior venacava. We planned to proceed with a permanent pacemaker implantation (VVI) with active fixation through the left subclavian vein following which he had a lead dislodgement on the 7th post procedure day. The pacemaker lead was later repositioned in a more stable position with a smaller loop and he is doing well on follow up. Permanent pacemaker implantation through a persistent left superior venacava is a technically challenging procedure and prone for complications and hence the importance of this case.

Source: Journal of Indian College of Cardiology - July 10, 2018 Category: Cardiology Source Type: research