Abstract
The pacemaker insertion in a patient with a persistent left superior vena cava ( PLSVC ) presents many problems such as dislodgement of catheter tip, pacing and sensing failure, thrombosis of coronary sinus other than difficulty in the insertion of catheter tip.
We met two patients with PLSVC who could not be diagnosed as having PLSVC before operation. Anomalous position of catheter tip made us suspect the presence of PLSVC and it was confirmed by intraoperative angiography. Left subclavian puncture more lateral than usual made catheter insertion easier. Both right atrial and right ventricular pacing were successful with 60cm catheter which is inserted via PLSVC. For atrial pacing, J-shaped wire is not suitable because of difficulty in fixation.
Both of the two patients are doing well without any complication.
