title: Cardiac resynchronization therapy in a patient with persistent left superior vena cava draining into the coronary sinus and absent innominate vein: a case report and review of literature.
abstract: BACKGROUND
  Persistent left superior vena cava (PLSVC) is a rare congenital anomaly of the superior venous system that may be discovered at the time of cardiac implantable electronic device (CIED) implantation.
  
  
  RESULTS
  We present a subject who needed cardiac resynchronization therapy (CRT)-CIED implantation and was discovered to have PLSVC with absent innominate vein during the implant procedure. We were able to successfully implant a CRT-CIED using a right-sided approach via the right superior vena cava (SVC). We present a description of our implant technique and a brief review of the different aspects of CIED implantation in subjects with variants of PLSVC.
  
  
  CONCLUSIONS
  Superior venous anomalies such as PLSVC can make CIED implantation technically challenging. However, with increasing operator experience, cardiac imaging and appropriate tools successful CIED implantation is possible in almost all cases.
authors.affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Ave, Ottawa, Canada - K1Y 4W7.
authors.forename: Girish M
authors.initials: GM
authors.lastname: Nair
authors.affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Ave, Ottawa, Canada - K1Y 4W7.
authors.forename: Seeger
authors.initials: S
authors.lastname: Shen
authors.affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Ave, Ottawa, Canada - K1Y 4W7.
authors.forename: Pablo B
authors.initials: PB
authors.lastname: Nery
authors.affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Ave, Ottawa, Canada - K1Y 4W7.
authors.forename: Calum J
authors.initials: CJ
authors.lastname: Redpath
authors.affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Ave, Ottawa, Canada - K1Y 4W7.
authors.forename: David H
authors.initials: DH
authors.lastname: Birnie
keywords: Absent Innominate Vein; Cardiac Resynchronization Therapy; Coronary Sinus; Persistent Left Superior Vena Cava