Document Detail

An alternative approach for endocardial pacemaker lead implantation in patient with persistent left superior vena cava.
MedLine Citation:
PMID:  20422915     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Persistent left superior vena cava represents a congenital vascular defect of the venous system, which often makes standard 58 cm endocardial lead placement impossible. CASE OUTLINE: A right chamber approach by the left cephalic vein was tried. This was impossible because standard endocardial lead (SJM Isoflex 5 1646T, bipolar lead, 58 cm in length, body diameter 7 French) was too short for this patient. A unipolar lead for coronary sinus (Medtronic ATTEIN 4193-88), 88 cm in length, body diameter 4 French, was placed in the posterior branch of the coronary sinus. With such positioning of the lead, a VVI pacemaker pacing was enabled. The operation lasted for 48 minutes, and the time of total X-ray exposure was 9.6 minutes. The values that were achieved were: threshold 0.3 V, pulse width 0.37 ms, maximum R 22.55 mV. Ten months after the implantation, the values were: threshold 0.3 V, maximum R 28.8 mV. CONCLUSION: Persistent left superior vena cava in some cases makes standard 58 cm endocardial lead placement impossible due to its joining to the right atrium over the dilated coronary sinus. Coronary sinus lead placement in the posterior or lateral coronary sinus branch represents an acceptable alternative approach for pacemaker lead placement in these patients.
Vladimir Mitov; Zoran Perisi?; Tomislav Kosti?; Aleksandar Stojkovi?; Aleksandar Joli?; Aleksandar Aleksi?; Goran Milasinovi?
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Srpski arhiv za celokupno lekarstvo     Volume:  138     ISSN:  0370-8179     ISO Abbreviation:  Srp Arh Celok Lek     Publication Date:    2010 Jan-Feb
Date Detail:
Created Date:  2010-04-28     Completed Date:  2010-05-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0027440     Medline TA:  Srp Arh Celok Lek     Country:  Serbia    
Other Details:
Languages:  eng     Pagination:  85-7     Citation Subset:  IM    
Pacemaker Department, Medical Centre, Zajecar, Serbia.
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MeSH Terms
Pacemaker, Artificial*
Radiography, Thoracic
Sick Sinus Syndrome / therapy*
Vena Cava, Superior / abnormalities*,  radiography

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