Implantation of a cardiac resynchronization system for idiopathic dilated cardiomyopathy in a patient with persistent left superior vena cava using an experimental lead for left ventricular stimulation

A persistent left superior vena cava (PLSVC) was discovered at the implanta tion of a cardiac resynchronization system in a woman with an idiopathic di lated cardiomyopathy. Standard leads were used to obtain right ventricular and right atrial (RA) stimulation according to a formerly described techniq ue. The left ventricle was stimulated through the posterolateral vein of th e heart by a novel lead design to be used over a guidewire for placement. D espite expected difficulties in this anatomic situation, the research lead was positioned in 23 minutes.