Persistent left superior vena cava in a patient with an implanted dual-chamber pacing system in atrial fibrillation with tachycardia-bradycardia syndrome

Bratislava Medical Journal

article

Kenzhebek BIZHANOV¹  Adil BAIMBETOV²  Akmoldir SARSENBAYEVA²  Evgeny LYAN³  Kuat АBZALIYEV⁴ 

[1] Department of Health Policy and Organization, Al-Farabi Kazakh National University;Department of Interventional Cardiology and Arrhythmology, National Scientifi c Center of Surgery named after A.N. Syzganov;Cardiovascular Center, University Clinic Schleswig-Holstein;Consultative and Diagnostic Center, Research Institute of Cardiology and Internal Disease

关键词: atrial fibrillation;    persistent left superior vena cava;    sick sinus syndrome;    pacemaker implantation;    cardiac surgery;   

DOI  :  10.4149/BLL_2023_019

学科分类：医学（综合）

来源: AEPress, s.r.o.

【 摘 要 】

The relevance of the study is conditioned by the problem of implantation of an artificial cardiac pacemaker in atrial fibrillation in patients with tachy-brady syndrome according to the standard scheme related to the presence of a congenital anomaly, such as persistent left superior vena cava. The purpose of the study is to develop an operative method of implantation of a permanent two-chamber pacemaker in patients with tachy-brady syndrome with concomitant pathology of the persistent left superior vena cava. Research methods are the generally accepted clinical and instrumental examination of the patient, including taking anamnesis and a standard cardiological examination, electrocardiography, transthoracic echocardiography, plain radiography, angiocardiographic examination, and multispiral computed tomography, which, along with a general analysis, confirm the presence of tachy-brady syndrome with atrial fibrillation and congenital anomaly in the form of persistent left superior vena cava in patients. The study presents a developed model of surgical implantation of a permanent two-chamber pacemaker to stabilise the condition of patients with atrial fibrillation related to tachy-brady syndrome with concomitant persistent left superior vena cava; the standard implantation mechanism included the introduction of a radiopaque agent to clarify the anatomical structure of the vascular bed, further, its entry from the subclavian veins into the persistent left superior vena cava and into the cavity of the right atrium through the venous coronary sinus was detected, and then a gradual introduction of an endocardial right ventricular electrode was performed into the subclavian vein through the tricuspid valve along with its further positioning in the apex of the right ventricle; therefore, a permanent two-chamber pacemaker can be successfully installed, creating conditions for restoring sinus rhythm in this group of patients, which is of practical importance for the field of medicine (Tab. 3, Fig. 4, Ref. 20).

【 授权许可】

CC BY