How to Safely Implant a Dual-Chamber Pacemaker for Right Ventricular Outflow Tract Pacing in a Patient with Persistent Left Superior Vena Cava: A Step by Step Guide

The implementation of advanced endovascular electrophysiological methods in patients with congenital venous anomalies (CVA) remains understudied.1 Patients with CVA have an average life expectancy. At times requiring interventional management of dysrhythmias, CVA can pose a challenge for the placement of implantable pacing devices. Persistent left superior vena cava (PLSVC) is the most common venous congenital anomaly. Herein the author discusses a safe technique of transvenous pacing lead implantation into right ventricular outflow tract (RVOT) and right atrial appendage in a 70-year-old patient with PLSVC