RIGHT-VENTRICULAR IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR LEAD IMPLANTATION THROUGH A PERSISTENT LEFT SUPERIOR VENA-CAVA

A 60-year-old woman required implantation of an ICD because of a hypot ensive ventricular tachycardia refractory to four different antiarrhyt hmic drugs. Preoperative diagnostics revealed a persistent left SVC as the only major venous return from the upper part of the body to She h eart. Under local anesthesia, a tripolar lead was advanced through the left SVC into the right ventricular apex. Following successful testin g, an active can ICD device was implanted, which is functioning well d uring a follow-up period of 9 months.