Persistent Left Superior Vena Cava in Pacemaker Implantation for Digoxin‐Induced Complete Heart Block: Clinical Considerations and Challenges

ABSTRACT Duplication of the superior vena cava is a rare congenital anomaly. Although often asymptomatic, this anatomical variation can complicate cardiovascular procedures, particularly those involving central venous access. We present the case of an 82‐year‐old female with multiple comorbidities,...

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Main Authors: Abdalhakim Shubietah, Mahmoud Doudein, Islam Rajab, Saad Mashaqi, Alaa Hmeedan, Qutaiba Qafisheh, Abdalrahman Assaassa
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Clinical Case Reports
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Online Access:https://doi.org/10.1002/ccr3.70227
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author Abdalhakim Shubietah
Mahmoud Doudein
Islam Rajab
Saad Mashaqi
Alaa Hmeedan
Qutaiba Qafisheh
Abdalrahman Assaassa
author_facet Abdalhakim Shubietah
Mahmoud Doudein
Islam Rajab
Saad Mashaqi
Alaa Hmeedan
Qutaiba Qafisheh
Abdalrahman Assaassa
author_sort Abdalhakim Shubietah
collection DOAJ
description ABSTRACT Duplication of the superior vena cava is a rare congenital anomaly. Although often asymptomatic, this anatomical variation can complicate cardiovascular procedures, particularly those involving central venous access. We present the case of an 82‐year‐old female with multiple comorbidities, who was incidentally found to have a persistent left superior vena cava (PLSVC) during pacemaker implantation for digoxin‐induced complete heart block. The initial pacemaker implantation on the left side was unsuccessful due to resistance, which led to the identification of PLSVC via contrast‐enhanced CT scan. The procedure was successfully completed by shifting the implantation to the right side. This case highlights the importance of recognizing venous anomalies such as PLSVC during interventional procedures, as early identification can prevent complications and inform surgical strategy. Awareness of such congenital variations is essential, particularly in patients with complex medical histories.
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series Clinical Case Reports
spelling doaj-art-86eca1d91d574314a34f553fa1ceb69f2025-08-20T02:50:55ZengWileyClinical Case Reports2050-09042025-03-01133n/an/a10.1002/ccr3.70227Persistent Left Superior Vena Cava in Pacemaker Implantation for Digoxin‐Induced Complete Heart Block: Clinical Considerations and ChallengesAbdalhakim Shubietah0Mahmoud Doudein1Islam Rajab2Saad Mashaqi3Alaa Hmeedan4Qutaiba Qafisheh5Abdalrahman Assaassa6Department of Internal Medicine Advocate Illinois Masonic Medical Center Chicago Illinois USACardiology Department Specialized Arab Hospital Nablus PalestineDepartment of Internal Medicine St. Joseph's University Medical Center Paterson New Jersey USAHead of Cardiology Department Specialized Arab Hospital Nablus PalestineDepartment of Internal Medicine An‐Najah National University Hospital Nablus PalestineDepartment of Internal Medicine University of Toledo Toledo Ohio USADepartment of Cardiology Thomas Jefferson University Hospital Philadelphia Pennsylvania USAABSTRACT Duplication of the superior vena cava is a rare congenital anomaly. Although often asymptomatic, this anatomical variation can complicate cardiovascular procedures, particularly those involving central venous access. We present the case of an 82‐year‐old female with multiple comorbidities, who was incidentally found to have a persistent left superior vena cava (PLSVC) during pacemaker implantation for digoxin‐induced complete heart block. The initial pacemaker implantation on the left side was unsuccessful due to resistance, which led to the identification of PLSVC via contrast‐enhanced CT scan. The procedure was successfully completed by shifting the implantation to the right side. This case highlights the importance of recognizing venous anomalies such as PLSVC during interventional procedures, as early identification can prevent complications and inform surgical strategy. Awareness of such congenital variations is essential, particularly in patients with complex medical histories.https://doi.org/10.1002/ccr3.70227anatomical variationdouble SVCinterventional cardiologypacemakerpersistent left superior vena cava
spellingShingle Abdalhakim Shubietah
Mahmoud Doudein
Islam Rajab
Saad Mashaqi
Alaa Hmeedan
Qutaiba Qafisheh
Abdalrahman Assaassa
Persistent Left Superior Vena Cava in Pacemaker Implantation for Digoxin‐Induced Complete Heart Block: Clinical Considerations and Challenges
Clinical Case Reports
anatomical variation
double SVC
interventional cardiology
pacemaker
persistent left superior vena cava
title Persistent Left Superior Vena Cava in Pacemaker Implantation for Digoxin‐Induced Complete Heart Block: Clinical Considerations and Challenges
title_full Persistent Left Superior Vena Cava in Pacemaker Implantation for Digoxin‐Induced Complete Heart Block: Clinical Considerations and Challenges
title_fullStr Persistent Left Superior Vena Cava in Pacemaker Implantation for Digoxin‐Induced Complete Heart Block: Clinical Considerations and Challenges
title_full_unstemmed Persistent Left Superior Vena Cava in Pacemaker Implantation for Digoxin‐Induced Complete Heart Block: Clinical Considerations and Challenges
title_short Persistent Left Superior Vena Cava in Pacemaker Implantation for Digoxin‐Induced Complete Heart Block: Clinical Considerations and Challenges
title_sort persistent left superior vena cava in pacemaker implantation for digoxin induced complete heart block clinical considerations and challenges
topic anatomical variation
double SVC
interventional cardiology
pacemaker
persistent left superior vena cava
url https://doi.org/10.1002/ccr3.70227
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