title: Implantation of a biventricular pacing and defibrillator device via a persistent left superior vena cava.
abstract: A persistent left superior vena cava was discovered in a 66-year-old man with heart failure undergoing implantation of a biventricular pacing and defibrillator device. An active fixation right ventricular defibrillator lead was placed through a curved guiding catheter. A sub-selection catheter and a guidewire allowed the engagement of a posterior-lateral branch of the coronary sinus, performance of an angiogram without an occlusive balloon, and optimal lead placement. The right atrial lead was positioned using a standard stylet. Despite the technical challenges, implantation of a biventricular pacing and defibrillator device via a persistent left superior vena cava is safe and feasible.
authors.affiliation: Interventional Cardiology, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Kapetanopoulos
authors.forename: Gene
authors.initials: G
authors.lastname: Peckham
authors.forename: Francis
authors.initials: F
authors.lastname: Kiernan
authors.forename: Christopher
authors.initials: C
authors.lastname: Clyne
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kluger
authors.forename: Magdy A
authors.initials: MA
authors.lastname: Migeed
mesh_terms: D000368:Aged; D017147:Defibrillators, Implantable; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D014683:Vena Cava, Superior / Q000002:abnormalities*; D018487:Ventricular Dysfunction, Left / Q000628:therapy*