Conduction System Pacing in a Patient with Persistent Left Superior Vena Cava and Absent Right Superior Vena Cava

Case Report

Volume 6, Issue 3 (March Issue)

Conduction System Pacing in a Patient with Persistent Left Superior Vena Cava and Absent Right Superior Vena Cava

Oriol Rodriguez-Queralto, Carlos Gonzalez-Matos, Fatima Zaraket, Benjamin Casteig, Jesús Jimenez-Lopez and Ermengol Valles^*

Electrophysiology Unit, Cardiology Department, Hospital del Mar. Institut Hospital del Mar Investigacions Mèdiques (IMIM), Universitat Pompeu Fabra, Barcelona, Spain

^*Corresponding author: Ermengol Valles Gras, Hospital del Mar. Cardiovascular Division, Electrophysiology Unit, 25-27 Passeig marítim de la Barceloneta, Barcelona, 08003 Spain. E-mail: ermengolvalles@mac.com

Received: February 28, 2024; Accepted: March 13, 2024; Published: March 25, 2024

Citation: Queralto OR, Matos CG, Valles E, et al. Conduction System Pacing in a Patient with Persistent Left Superior Vena Cava and Absent Right Superior Vena Cava. Clin Image Case Rep J. 2024; 6(3): 386.

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Conduction System Pacing in a Patient with Persistent Left Superior Vena Cava and Absent Right Superior Vena Cava

Abstract

Background: Physiologic pacing is increasingly used as an alternative when there is a failure in cardiac resynchronization therapy (CRT), with more challenging situations expected consequently.

Case Presentation: An 83-year-old Caucasian man underwent attempted CRT, but was found to have a persistent left superior vena cava (SVC) and absence of a right SVC. Additionally, no suitable coronary sinus (CS) veins were found. Instead, conduction system pacing with a modified approach was used.

Conclusions: The presence of left superior SVC is compatible with safe implantation of conduction system pacing, using conventional tools and with mild modification of typical technique.

Keywords: Conduction system pacing; Cardiac resynchronization therapy; Persistent left superior vena cava; Cardiology