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An Uncommon Dilemma: Cardiac Resynchronization Therapy in Patients With Persistent Left Superior Vena Cava Draining Into The Coronary Sinus

Persistent left superior vena cava (PLSVC) is a congenital venous developmental abnormality of the sinus venosus with an incidence of 0.47% in patients undergoing cardiac implantable electronic devices. The two variants include a double superior vena cava (right and left SVC, with or without an innominate vein connecting the two) or a single left sided SVC (without a rightSVC).1 Implantation of cardiac implantable electronic devices (CIED), especially cardiac resynchronization therapy (CRT), may be challenging in the presence of PLSVC.2The authors present two cases in which CRT was successfully implanted with PLSVC. The authors also provide a systematic approach that can be adopted during implantation of CIED in patients with PLSVC.

Credits: Omar R. Kahaly, MD;Muhammad R. Afzal, MD; Toshimasa Okabe, MD Mahmoud Houmsse, MD

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