Key result
Temporary pacemaker lead in PLSVC shows unusual fluoroscopic course with RV, RA, and LV pacing.
Case Report (n=1)
Highlights the unusual radiographic and electrocardiographic patterns that can occur during temporary pacing in patients with persistent left superior vena cava.
Unusual lead trajectories in PLSVC warrant consideration during temporary pacing; leaves open systematic study of multi-chamber capture in congenital venous anomalies.
Persistent left superior vena cava (PLSVC) results from abnormal development of the sinus venosus in the early stages of fetal life. Though there are numerous reports of successful permanent pacemaker implants in such cases, placement of permanent pacing leads in such cases is technically challenging, often requiring shaping of stylets and considerable lead maneuvering. We describe an interesting case wherein a temporary pacemaker lead after entering the PLSVC followed an unusual fluoroscopic course with demonstrable pacing in right ventricle (RV), right atrium (RA) and the left ventricle (LV). Interventional cardiologists and intensivists performing pacing procedures need to be aware that one may rarely encounter such interesting radiographic and electrocardiographic patterns in these cases with anomalous systemic venous drainage.
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Kapoor et al. (2012) conducted a case report in Persistent left superior vena cava (PLSVC) (n=1). Temporary pacemaker lead placement was evaluated on Fluoroscopic course and pacing locations. Temporary pacemaker lead placement in a patient with persistent left superior vena cava followed an unusual fluoroscopic course with demonstrable pacing in the right ventricle, right atrium, and left ventricle.
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