Conduction system pacing in a patient with persistent left superior vena cava and absent right superior vena cava: a case report.

BACKGROUND

Physiologic pacing is increasingly used as an alternative when there is a failure in cardiac resynchronization therapy, with more challenging situations expected consequently.

CASE PRESENTATION: An 83 year-old Caucasian man underwent attempted cardiac resynchronization therapy, but was found to have a persistent left superior vena cava and absence of a right superior vena cava. In addition, no suitable coronary sinus veins were found. Instead, conduction system pacing with a modified approach was used.

CONCLUSION

The presence of left superior vena cava is compatible with safe implantation of conduction system pacing, using conventional tools and with mild modification of typical technique.