Key result
Femoral Micra AV achieves ~77% AV synchrony in isolated persistent left superior vena cava.
Why the study?
Isolated persistent left superior vena cava (PLSVC) limits access during transvenous pacemaker implantation, requiring alternative strategies and technical considerations.
Case Report (n=1)
No
Leadless pacemaker implantation via the femoral vein is a feasible and effective alternative to transvenous pacemakers in patients with isolated persistent left superior vena cava, successfully avoiding complex venous anatomies while achieving acceptable atrioventricular synchrony.
May offer femoral access alternative in PLSVC; leaves open generalizability pending larger prospective data.
Isolated persistent left superior vena cava (PLSVC) provides limited access during transvenous pacemaker implantation. We present a case of implantation of a leadless pacemaker for atrioventricular block with isolated PLSVC. A leadless pacemaker is an alternative strategy to a transvenous pacemaker; however, some technical tips are required: (1) the prevention of the mis-insertion in the dilated coronary sinus and (2) the pre-assessment of the anatomy of the right atrium and ventricle.
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Tokonami et al. (2025) conducted a case report in Atrioventricular block with isolated persistent left superior vena cava (n=1). Leadless pacemaker (Micra AV) was evaluated on Successful implantation and atrioventricular synchrony. A leadless pacemaker (Micra AV) was successfully implanted via the right femoral vein in a patient with isolated persistent left superior vena cava, achieving 77.3% atrioventricular synchrony at 6 months.