Key result
Right-sided dual chamber LBBAP succeeds without complications in PLSVC and high-grade AV block.
Why the study?
Persistent left superior vena cava can complicate transvenous device implantation due to challenging venous anatomy and limited sheath support during physiologic pacing lead delivery.
Case Report (n=1)
Right-sided LBBAP is a feasible and effective pacing strategy for patients with persistent left superior vena cava when traditional venous routes are challenging.
May extend pacing options in persistent left SVC; hypothesis-generating and should not yet change practice.
Background: Persistent left superior vena cava (PLSVC) can complicate transvenous device implantation due to challenging venous anatomy and limited sheath support during physiologic pacing lead delivery. Case Summary: A woman in her mid-40s evaluated for a syncopal episode had ambulatory electrocardiography showing high-grade atrioventricular block with prolonged pauses, deemed irreversible, leading to plans for a permanent pacemaker. Intraprocedural venography identified a PLSVC. A right-sided dual chamber left bundle branch area pacing (LBBAP) was successfully performed. The procedure was uncomplicated, and follow-up with cardiology was arranged. Discussion: Right-sided LBBAP can be feasible and associated with positive outcomes in patients with PLSVC, and it should be considered a strong option when traditional venous routes are difficult. Early detection and adaptable pacing strategies are essential for maximizing outcomes in such patients.
No takes yet. Share an insight, caveat, or question.
Shrestha et al. (2026) conducted a case report in High-grade atrioventricular block and persistent left superior vena cava (n=1). Right-sided dual chamber left bundle branch area pacing (LBBAP) was evaluated on Procedural success and complications. Right-sided dual chamber left bundle branch area pacing was successfully performed without complications in a patient with persistent left superior vena cava and high-grade AV block.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: