title: Screw-in atrial lead in a sick sinus syndrome patient with anomalous inferior vena cava.
abstract: Anomalous inferior vena cava without intracardiac anomaly is an unusual condition. Herein, we report a 48-year-old female with left-sided inferior vena cava and azygous continuation. accompanied by sick sinus syndrome. This anomaly resulted in difficulty in implanting a traditional hook-on atrial lead. Atrial lead dislodgment occurred repeatedly soon after implanting the pacemaker because of an anomalous zygous vein draining into the superior vena cava, making a giant connection with the right atrium, thus eliminating the space of the atrial appendage for lead lodgment. Finally, we attempted to utilize a screw-in atrial lead in this patient and she is currently doing well. We therefore suggest that a screw-in atrial lead should be taken into account for such patients in order to obtain a stable fixation.
authors.affiliation: Department of Medicine, Chang Gung University, and Chang Gung Memorial Hospital-Linkou, Taipei, Taiwan.
authors.forename: K H
authors.initials: KH
authors.lastname: Lin
authors.forename: C T
authors.initials: CT
authors.lastname: Kuo
authors.forename: C T
authors.initials: CT
authors.lastname: Lin
mesh_terms: D001401:Azygos Vein / Q000002:abnormalities; D004567:Electrodes, Implanted; D004867:Equipment Design; D005260:Female; D006325:Heart Atria; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012804:Sick Sinus Syndrome / Q000150:complications / Q000628:therapy*; D014682:Vena Cava, Inferior / Q000002:abnormalities*