Percutaneous permanent pacemaker implantation via the azygous vein in a patient with superior vena cava occlusion

Pacing and Clinical Electrophysiology : PACE
Ravindu Hasmukh Kamdar, Richard John Schilling


Occlusion of the superior vena cava (SVCO) makes implantation of permanent pacemakers challenging and difficult. We describe an extended application of a Medtronic Attain (Medtronic Inc., Minneapolis, MN, USA) guide catheter (a tool designed for delivery of left ventricular pacing leads into the coronary sinus) for delivery of a right ventricular pacing lead via the azygous vein in a 72-year-old woman with SVCO secondary to long-term central venous hemodialysis catheters. This approach allowed the use of an endocardial pacing lead, implantation under local anesthesia, and conventional positioning of the pacemaker generator in the pectoral region in a patient with SVCO.


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Related Concepts

Structure of Azygous Vein
Artificial Cardiac Pacemaker
Superior Vena Cava Thrombosis
Prosthesis Implantation
Local Anesthesia
Implantation Procedure
Needle Device
Superior Vena Cava Structure

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