IMPLANTATION OF DUAL-CHAMBER PACEMAKER IN A PATIENT WITH PERSISTENT LEFT SUPERIOR VENA-CAVA

A 35-year-old patient underwent permanent pacemaker implantation becau se of symptomatic sinus bradycardia. During the procedure, persistent left superior vena cava was found. The ventricular lead crossed the tr icuspid valve only after curving the stylet to form a loop in the righ t atrium (RA); subsequently, the curved stylet was changed to a straig ht one and the lead was positioned and screwed into the right ventricu lar apex. The atrial lead positioning wets possible when the stylet wa s slightly curved and the lead could reach the anterior wall of the RA . At 18 months, a follow-up revealed normal pacemaker-function and sta ble lead position.