Key result
A "three-dimensional alpha curve"-shaped stylet facilitated successful pacing lead entry into the right ventricle in an adult male with persistent left superior vena cava.
Case Report (n=1)
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A novel '3D alpha curve' stylet shape can facilitate right ventricular lead placement in patients with persistent left superior vena cava when standard stylet shapes fail.
Persistent left superior vena cava (PLSVC) draining into coronary sinus is typically detected incidentally during transcatheter interventions using left subclavian venous approach. In our experience, we have encountered this anomaly on a few occasions and in all these cases we successfully implanted leads in the right ventricle (RV) by shaping the stylet into a "U-shaped" or "pigtail-shaped" curve. Herein, we report a case of an adult male who underwent successful dual-chamber pacemaker implantation via PLSVC through left axillary venous approach. In this case, we were unable to deliver the lead into RV using aforementioned stylets. As an innovation, we used a "three-dimensional alpha curve"-shaped stylet that facilitated an easy entry of pacing lead into the RV.
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Beig et al. (2017) conducted a case report in Persistent left superior vena cava requiring pacemaker implantation (n=1). "Three-dimensional alpha curve"-shaped stylet was evaluated on Successful lead implantation in the right ventricle. A "three-dimensional alpha curve"-shaped stylet facilitated successful pacing lead entry into the right ventricle in an adult male with persistent left superior vena cava.
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