Detection of a left superior vena cava during a pacemaker im
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We report the case of a 54-year-old man, a former smoker who consulted for dyspnea and dizziness. Physical examination noted blood pressure at 170/80 mmHg, signs of heart failure and regular bradycardia at 40 per minute. The diagnosis of complete atrioventricular block with wide QRS complex (complete right bundle branch block) was made on the electrocardiogram.Transthoracic echocardiography showed moderately dilated left cardiac cavities , high left ventricular filling pressure and a dilated inferior vena cava. There was no pulmonary arterial hypertension.It was decided to implant a cardiac pacemaker and the patient was taken to the cardiac catheterization room. After its introduction into the left cephalic vein, the right ventricular pacing lead descended along the left side of the spine following the path of a LSVC and entered the right atrium through the coronary sinus (figure n?1). The attempt to ascend the stimulation lead into the RSVC starting from the right atrium failed, suggesting the persistence of LSVC with absence of RSVC....

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