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Case Reports
. 2017 Sep;40(9):1042-1044.
doi: 10.1111/pace.13075. Epub 2017 Apr 25.

An Innovation in Pacemaker Lead Implantation via Persistent Left Superior Vena Cava: The "3D Alpha Curve" Stylet

Jahangir Rashid Beig  1 , Mohd Iqbal Dar  1 , Nisar A Tramboo  1 , Imran Hafeez  1 , Ajaz A Lone  1 , Hilal A Rather  1
Affiliations
Case Reports

An Innovation in Pacemaker Lead Implantation via Persistent Left Superior Vena Cava: The "3D Alpha Curve" Stylet

Jahangir Rashid Beig et al. Pacing Clin Electrophysiol. 2017 Sep.

Abstract

Persistent left superior vena cava (PLSVC) draining into coronary sinus is typically detected incidentally during transcatheter interventions using left subclavian venous approach. In our experience, we have encountered this anomaly on a few occasions and in all these cases we successfully implanted leads in the right ventricle (RV) by shaping the stylet into a "U-shaped" or "pigtail-shaped" curve. Herein, we report a case of an adult male who underwent successful dual-chamber pacemaker implantation via PLSVC through left axillary venous approach. In this case, we were unable to deliver the lead into RV using aforementioned stylets. As an innovation, we used a "three-dimensional alpha curve"-shaped stylet that facilitated an easy entry of pacing lead into the RV.

Keywords: permanent pacemaker implantation; persistent left superior vena cava; “3D alpha curve” stylet.

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