DEFIBRILLATOR IMPLANTATION IN A PATIENT WITH A PERSISTENT LEFT SUPERIOR VENA-CAVA

The implantation of a transvenous cardioverter defibrillator (PCD 7217 B) was performed in a patient with a persistent left superior vena cav a. The defibrillation electrodes were positioned in the right ventricl e and the superior vena cava via the right subclavian vein. A subcutan eous patch had to be implanted at the left lateral chest wall to achie ve sufficient defibrillation thresholds. Three weeks later the system had to be removed because of a generator pocket infection. During the second implantation we placed one electrode in the persistent left sup erior vena cava perpendicular to the electrode in the right ventricle. Using this configuration transvenous defibrillation was possible with out an additional subcutaneous patch.