Key result
Coronary sinus lead implantation succeeds via PLSVC despite absent right atrial communication.
Case Report (n=1)
Demonstrates a successful alternative approach for biventricular pacemaker lead implantation in a patient with a coronary sinus anomaly.
Feasible alternative access for biventricular pacing in rare venous anomalies; leaves open generalizability to routine practice.
Intubation of the coronary sinus failed during implantation of a biventricular pacing system. An angiogram of the left coronary artery showed in the venous phase a coronary sinus not communicating with the right atrium. The coronary sinus was draining into a persistent left superior vena cava communicating with the left subclavian vein. The coronary sinus lead was successfully implanted through the persistent left superior vena cava, whereas the atrial and ventricular leads were implanted through the right superior vena cava in a conventional way.
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Gelder et al. (2003) conducted a case report in Coronary sinus not communicating with the right atrium during biventricular pacing system implantation (n=1). Implantation of a biventricular pacing system via persistent left superior vena cava was evaluated on Successful implantation. A coronary sinus lead was successfully implanted through a persistent left superior vena cava in a patient whose coronary sinus did not communicate with the right atrium.
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