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KMID : 1011920150160020113
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International Journal of Arrhythmia
2015 Volume.16 No. 2 p.113 ~ p.116
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Successful Implantable Cardioverter Defibrillator Implantation in a Patient with Persistent Left Superior Vena Cava and Atrial Septal Defect
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Lee Ki-Hong
Park Hyung-Wook
Yoon Nam-Sik
Kim Sung-Soo
Cho Jeong-Gwan
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Abstract
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Use of an implantable cardioverter defibrillator (ICD) is the treatment of choice in patients experiencing sudden cardiac arrest. However, the presence of persistent left superior vena cava (PLSVC) presents technical challenges and complicates the ICD implantation because of the high frequency of accompanying congenital anomalies. We report on a right-handed 34 year-old male patient with PLSVC and atrial septal defect undergoing successful ICD implantation in the left anterior chest. The patient had been successfully resuscitated from idiopathic ventricular fibrillation. Computed tomography demonstrated dual SVC with a rudimentary cross-connection. However, the guide-wire did not cross the innominate vein. Therefore, the placement of an ICD lead at the right atrium over the huge coronary sinus was decided. Access to the right ventricle was gained by using a hand-shaped r-shaped stylet, with its distal end perpendicular to the proximal part. An ICD lead was positioned at the right ventricular apex with satisfactory measurement.
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KEYWORD
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Defibrillators, Implantable, Vena Cava, Superior, Heart Septal Defects, Atrial
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