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Published online: 2024-03-21

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Cardiac resynchronization therapy defibrillator upgrade with the atrial and left ventricular leads introduction through the persistent left superior vena cava facilitated by the balloon angioplasty

Joanna Popiolek-Kalisz12, Tomasz Chrominski1, Marcin Szczasny1, Piotr Blaszczak1

Abstract

The persistent left superior vena cava is the systemic venous system malformation observed in 0.1–0.5% of
the general population. It can result in many obstacles in pacemaker implantation.
The report presents a case of a 62-year-old male patient who underwent an upgrade of his implantable
cardioverter-defibrillator to a cardiac resynchronization therapy defibrillator. The patient initially had a one-
-chamber cardioverter-defibrillator implanted in 2014. Due to advanced symptomatic dilated cardiomyopathy
co-existing with significant nonspecific intraventricular conduction delay, the patient was qualified for a device
upgrade in 2023, i.e. implantation of additional atrial and left ventricular electrodes. The obstruction in the
brachiocephalic vein and the presence of the persistent left superior vena cava were revealed in the course of
the procedure. The result was a successful upgrade to cardiac resynchronization therapy defibrillator with the
combination of the defibrillation right ventricular lead implanted originally through the right superior vena cava
and the atrial and left ventricular electrodes implanted through the persistent left superior vena cava.
The presented case describes the acceptable approach in the course of implantable cardioverter-defibrillator
upgrade to cardiac resynchronization therapy defibrillator in the case of the persistent left superior vena cava
and the brachiocephalic vein obstruction.

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References

  1. Zhong YL, Long XM, Jiang LY, et al. Surgical treatment of dextroversion, isolated persistent left superior vena cava draining into the left atrium. J Card Surg. 2015; 30(10): 767–770.
  2. Ruano CA, Marinho-da-Silva A, Donato P. Congenital thoracic venous anomalies in adults: morphologic MR imaging. Curr Probl Diagn Radiol. 2015; 44(4): 337–345.
  3. Hsu LF, Jaïs P, Keane D, et al. Atrial fibrillation originating from persistent left superior vena cava. Circulation. 2004; 109(7): 828–832.
  4. Girerd N, Gressard A, Berthezene Y, et al. Persistent left superior vena cava with absent right superior vena cava: a difficult cardiac pacemaker implantation. Int J Cardiol. 2009; 132(3): e117–e119.
  5. Li T, Xu Q, Liao HT, et al. Transvenous dual-chamber pacemaker implantation in patients with persistent left superior vena cava. BMC Cardiovasc Disord. 2019; 19(1): 100.
  6. Kumar S, Moorthy N, Kapoor A, et al. A challenging dual chamber permanent pacemaker implantation in persistent left superior vena cava with absent right superior vena cava. J Cardiol Cases. 2012; 5(2): e122–e124.
  7. Dąbrowski P, Obszański B, Kleinrok A, et al. Long-term follow-up after pacemaker implantation via persistent left superior vena cava. Cardiol J. 2014; 21(4): 413–418.
  8. Nicolis D, Mugnai G, Pepi P, et al. Active fixation of bipolar left ventricular lead through a persistent left superior vena cava. J Arrhythm. 2022; 38(3): 488–490.
  9. Narikawa M, Kiyokuni M, Taguchi Y, et al. Successful implantation of left ventricular lead for a cardiac resynchronization therapy defibrillator through a persistent left superior vena cava using the anchor balloon technique. J Cardiol Cases. 2022; 25(5): 308–311.
  10. Ponnusamy SS, Syed T, Basil W. Left bundle branch optimized cardiac resynchronization therapy in mesocardia with bilateral superior vena cava. JACC Clin Electrophysiol. 2022; 8(3): 406–409.
  11. Prolič Kalinšek T, Žižek D. Right-sided approach to left bundle branch area pacing combined with atrioventricular node ablation in a patient with persistent left superior vena cava and left bundle branch block: a case report. BMC Cardiovasc Disord. 2022; 22(1): 467.
  12. Schummer W, Schummer C, Fröber R. Persistent left superior vena cava and central venous catheter position: clinical impact illustrated by four cases. Surg Radiol Anat. 2003; 25(3-4): 315–321.
  13. Nair GM, Shen S, Nery PB, et al. Cardiac resynchronization therapy in a patient with persistent left superior vena cava draining into the coronary sinus and absent innominate vein: a case report and review of literature. Indian Pacing Electrophysiol J. 2014; 14(5): 268–272.
  14. Fujibayashi K, Saeki Y, Sawaguchi J, et al. A case of cardiac resynchronization therapy in a patient with coronary sinus ostial atresia and persistent left superior vena cava. J Cardiol Cases. 2020; 21(3): 101–103.
  15. Biffi M, Massaro G, Diemberger I, et al. Cardiac resynchronization therapy in persistent left superior vena cava: Can you do it two-leads-only? HeartRhythm Case Rep. 2017; 3(1): 30–32.
  16. Cardiac resynchronization therapy device implantation in a patient with persistent left superior vena cava without communicating innominate vein - should we proceed from the same side? - A dilemma revisited - ScienceDirect n.d. https://www.sciencedirect.com/science/article/pii/S0972629217302012?via%3Dihub (accessed October 29, 2023).
  17. Bontempi L, Aboelhassan M, Cerini M, et al. Technical considerations for CRT-D implantation in different varieties of persistent left superior vena cava. J Interv Card Electrophysiol. 2021; 61(3): 517–524.
  18. Ghazzal B, Sabayon D, Kiani S, et al. Cardiac implantable electronic devices in patients with persistent left superior vena cava-A single center experience. J Cardiovasc Electrophysiol. 2020; 31(5): 1175–1181.
  19. Risk factors for cardiac implantable electronic device infection: a systematic review and meta-analysis | EP Europace | Oxford Academic n.d. https://academic.oup.com/europace/article/17/5/767/2467134?login=false (accessed October 29, 2023).