Transvenous cardiac implantable electronic device implantation in patients with persistent left superior vena cava in a tertiary center.

PURPOSE: Persistent left superior vena cava (PLSVC) is rare and often asymptomatic, which might cause difficulties in the implantation of cardiac implantable electronic devices (CIEDs). The aim of this study was to determine the prevalence of PLSVC and to study the clinical characteristics and significance of PLSVC in patients with CIED implantation.

METHODS

Thirty-three patients with PLSVC were collected from 7047 CIED recipients over recent 10 years in our center. These 33 patients were divided into three groups: PLSVC in the absence of RSVC, with a pacemaker implantation (group A, n = 7); double superior vena cava (DSVC), having both PLSVC and RSVC, with a pacemaker or implantable cardioverter defibrillator (ICD) implantation (group B, n = 20); DSVC with a cardiac resynchronization therapy/cardiac resynchronization therapy defibrillator (CRT/CRT-D) implantation (group C, n = 6). The clinical characteristics, pacing parameters, and complications were collected and compared among three groups.

RESULTS

The prevalence of PLSVC in our patients implanting CIEDs in the recent 10 years was 0.47%. Coronary sinus diameter, right atrium lead type (active or passive), right atrium lead location (right atrium appendage or lateral wall), right ventricle lead location (right ventricular apex or right ventricular outflow tract), and procedure duration were found to be significantly different among three groups, while the incidence of complications and pacing parameters was not significantly different among three groups during long-term follow-up.

CONCLUSIONS

Although the presence of PLSVC made the CIED implantation more challenging and might increase the complications related to the procedure, the pacing parameters were not likely to be affected during long-term follow-up.