Successful implantation of a leadless pacemaker in a patient with complete atrioventricular block and congenital absence of superior vena cava: a case report.
Case report
Complete atrioventricular block
Congenital absence of superior vena cava
Leadless pacemaker
Persistent left superior vena cava
Systemic venous anomalies
Journal
European heart journal. Case reports
ISSN: 2514-2119
Titre abrégé: Eur Heart J Case Rep
Pays: England
ID NLM: 101730741
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
02
11
2020
revised:
25
11
2020
accepted:
14
04
2021
entrez:
14
6
2021
pubmed:
15
6
2021
medline:
15
6
2021
Statut:
epublish
Résumé
Congenital absence of superior vena cava (CASVC) is an extremely rare vascular anomaly often associated with conduction disturbances which makes implantation of a pacemaker difficult. We report a case of pacemaker implantation in a patient presenting with complete atrioventricular block (c-AVB) with bilateral absence of the SVC. A 68-year-old man who had experienced dyspnoea on exertion by c-AVB was admitted to our hospital for treatment and management. Permanent pacemaker insertion was initially planned; however, an endocardial pacemaker lead could not be implanted in the right atrium. Computed tomography scan with contrast revealed that the venous blood from the upper half of the body flowed into the inferior vena cava via the azygos vein. Due to the difficulty of inserting an endocardial lead from the subclavian vein, a leadless pacemaker (LP) was implanted instead via the femoral vein. This is the first case of an LP implantation in a patient presenting with c-AVB with CASVC. Confirmation of blood vessel anatomy to rule out CASVC is necessary prior to pacemaker implantation when abnormal venous anatomy is suspected.
Sections du résumé
BACKGROUND
BACKGROUND
Congenital absence of superior vena cava (CASVC) is an extremely rare vascular anomaly often associated with conduction disturbances which makes implantation of a pacemaker difficult. We report a case of pacemaker implantation in a patient presenting with complete atrioventricular block (c-AVB) with bilateral absence of the SVC.
CASE SUMMARY
METHODS
A 68-year-old man who had experienced dyspnoea on exertion by c-AVB was admitted to our hospital for treatment and management. Permanent pacemaker insertion was initially planned; however, an endocardial pacemaker lead could not be implanted in the right atrium. Computed tomography scan with contrast revealed that the venous blood from the upper half of the body flowed into the inferior vena cava via the azygos vein. Due to the difficulty of inserting an endocardial lead from the subclavian vein, a leadless pacemaker (LP) was implanted instead via the femoral vein.
DISCUSSION
CONCLUSIONS
This is the first case of an LP implantation in a patient presenting with c-AVB with CASVC. Confirmation of blood vessel anatomy to rule out CASVC is necessary prior to pacemaker implantation when abnormal venous anatomy is suspected.
Identifiants
pubmed: 34124567
doi: 10.1093/ehjcr/ytab167
pii: ytab167
pmc: PMC8189307
doi:
Types de publication
Case Reports
Langues
eng
Pagination
ytab167Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.
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