Transvenous Dual-Chamber Pacemaker Implantation in a Patient with Persistent Left Superior Vena Cava Undergoing Maintenance Hemodialysis

Toan Nguyen Duy,1,2 Luyen Nguyen Van,1,2 Anh Pham Phuong Thao,1,2 Binh Pham Thai,3 Hoang Ta Anh,2,4 Lam Pham Son,5 Thuc Luong Cong1,2 1Cardiovascular Center, Military Hospital 103, Hanoi, Vietnam; 2Cardiovascular Department, Vietnam Military Medical University, Hanoi, Vietnam; 3Internal Medicine Dep...

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Main Authors: Nguyen Duy T, Nguyen Van L, Pham Phuong Thao A, Pham Thai B, Ta Anh H, Pham Son L, Luong Cong T
Format: Article
Language:English
Published: Dove Medical Press 2025-02-01
Series:International Medical Case Reports Journal
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Online Access:https://www.dovepress.com/transvenous-dual-chamber-pacemaker-implantation-in-a-patient-with-pers-peer-reviewed-fulltext-article-IMCRJ
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Summary:Toan Nguyen Duy,1,2 Luyen Nguyen Van,1,2 Anh Pham Phuong Thao,1,2 Binh Pham Thai,3 Hoang Ta Anh,2,4 Lam Pham Son,5 Thuc Luong Cong1,2 1Cardiovascular Center, Military Hospital 103, Hanoi, Vietnam; 2Cardiovascular Department, Vietnam Military Medical University, Hanoi, Vietnam; 3Internal Medicine Department, Vietnam National Hospital of Endocrinology, Hanoi, Vietnam; 4Department of Cardiovascular Intervention, 175 Military Hospital, Ho Chi Minh city, Vietnam; 5Department of Cardiovascular Intensive Care, 108 Military Central Hospital, Hanoi, VietnamCorrespondence: Thuc Luong Cong, Affiliation: Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, 261 Phung Hung, Ha Dong, Hanoi, Vietnam, Tel +84982200646, Email lcthuc@gmail.comBackground: Persistent left superior vena cava (PLSVC) is a rare congenital venous anomaly. Permanent pacemaker implantation (PPI) in patients with PLSVC presents challenges in placing both the right ventricular and atrial leads. The article describes a technique for dual-chamber PPI using standard leads in a PLSVC patient with chronic kidney disease on maintenance hemodialysis.Case Presentation: A 69-year-old male patient with sick sinus syndrome (SSS), hypertension, moderate mitral regurgitation, dilated left ventricle, diabetes, chronic kidney disease (on hemodialysis), and NYHA III heart failure underwent dual-chamber pacemaker implantation via the left axillary vein. Venography revealed a persistent left superior vena cava, a challenge for the placement of leads. The ventricular lead was positioned in the right ventricular outflow tract using a Biotronik active fixation lead with a “C” shaped stylet, and the atrial lead was placed in the right atrial lateral wall. The procedure took 115 minutes with 17.5 minutes of fluoroscopy. After 4 months, the patient showed symptom improvement and stable pacing parameters.Conclusion: Dual chamber pacemaker implantation through PLSVC in a patient undergoing maintenance hemodialysis using a “C” shaped stylet technique is feasible, safe, and effective.Keywords: persistent left superior vena cava, permanent pacemaker, maintenance hemodialysis
ISSN:1179-142X