Key result
Implantation of a dual-coil ICD lead using a long sheath and deflectable catheter in a patient with a persistent left superior vena cava resulted in a very low defibrillation threshold (≤ 5 J).
Why the study?
Does the use of a long sheath guided by a deflectable catheter improve defibrillation threshold in a patient with a persistent left superior vena cava undergoing ICD implantation?
Case Report (n=1)
Does the use of a long sheath guided by a deflectable catheter improve defibrillation threshold in a patient with a persistent left superior vena cava undergoing ICD implantation?
Answers are grounded in this paper and cite their sources.
The use of a long sheath and deflectable catheter for ICD lead placement in a patient with PLSVC can achieve a unique dual-coil position resulting in a very low defibrillation threshold.
Several reports have described the successful insertion of implantable cardioverter defibrillator (ICD) in patients with a persistent left superior vena cava (PLSVC). The implanters have used various techniques to achieve appropriate lead placement. In our case, the use of a long sheath, guided by a deflectable catheter, not only facilitated proper implantation of the lead, but also provided a unique position of the dual-coil lead. This resulted in a very low defibrillation threshold (DFT). We describe a case of a patient found to have a PLSVC at implant who after successful insertion of the ICD exhibited DFT ≤ 5 J.
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Williams et al. (2012) conducted a case report in Persistent left superior vena cava requiring ICD (n=1). ICD insertion using a long sheath guided by a deflectable catheter was evaluated on Defibrillation threshold (DFT). Implantation of a dual-coil ICD lead using a long sheath and deflectable catheter in a patient with a persistent left superior vena cava resulted in a very low defibrillation threshold (≤ 5 J).
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