Right ventricular electrode lead implantation via a persistent left superior vena cava. An improved technique.

Persistent left superior vena cava occurs in approximately 0.5% of the population. This may complicate pacemaker implantation by making lead insertion difficult and causing lead instability through the left cephalic vein and the subclavian vein approach. We used a wide loop technique in the right atrium and successfully advanced the lead in the right ventricle apex. A persistent left superior vena cava does not preclude successful lead placement.