Transvenous cardioverter-defibrillator placement via a persistent left superior vena cava.
BACKGROUND
Persistent left superior vena cava (LSVC) is relatively uncommon. Due to its unanticipated location, large vessel injury is disproportionately common during transvenous intracardiac device implantation.


OBJECTIVE
The purposes of this report are: (1) to remind surgeons/physicians of this (LSVC) anatomic abnormality and, (2) to reassure surgeons/physicians that successful dysarrhythmia rescue is feasible with intracardiac defibrillator devices despite the obligate atypical anatomic positioning of the defibrillator electrodes.


METHODS
Catheter position in an LSVC appears fluoroscopically to traverse the left pleural space. The transvenous lead must negotiate a U-turn to enter the right ventricle.


CONCLUSIONS
Despite the unconventional configuration of the intracardiac electrodes necessitated by the anatomy of a persistent LSVC, successful defibrillation is possible.
Pavlić
Liesl K
LK
The Department of Medicine, Alameda County Medical Center, Oakland, California 94602, USA. Lpavlic@acmedctr.org
Harken
Alden H
AH
Sethna
Dhun
D
D000328:Adult; D002304:Cardiac Pacing, Artificial; D014355:Chagas Disease / Q000628:therapy; D017147:Defibrillators, Implantable; D006801:Humans; D008297:Male; D014683:Vena Cava, Superior / Q000002:abnormalities* / Q000601:surgery*