Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Oct 1997
Case Reports[Temporary and permanent pacemaker provision in persistent left superior vena cava and atresia of the right superior vena cava].
An 80-year-old woman was admitted because of confusion episodes, difficulty of finding words and transitory clouding of consciousness on that day. There were moderately moist rales over both lung bases and mild pretibial oedema. The ECG showed atrial fibrillation with an irregular ventricular rate of 30/min. Attempted emergency implantation of a pacemaker electrode via the right subclavian vein failed because the catheter could not be advanced in the usual manner due to complete obstruction of unknown cause. ⋯ If emergency placement of a pacemaker electrode proves impossible via the usual route because of a persistent LSVC and RSVC atresia, a transfemoral route should be used for temporary pacing. Permanent placement can usually be accomplished subsequently without much problem via the LSVC and coronary sinus.