Persistent left superior vena cava in a patient with an implanted dual-chamber pacing system in atrial fi brillation with tachycardia-bradycardia syndrome
Bizhanov K. Baimbetov A. Sarsenbayeva A. Lyan E. Аbzaliyev K.
2023Comenius University in Bratislava
Bratislava Medical Journal
2023#124Issue 2121 - 127 pp.
The relevance of the study is conditioned by the problem of implantation of an artifi cial cardiac pacemaker in atrial fi brillation 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 tachybrady 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, confi rm the presence of tachy-brady syndrome with atrial fi brillation 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 fi brillation 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 fi eld of medicine (Tab. 3, Fig. 4, Ref. 22). Text in PDF www.elis.sk
atrial fi brillation , cardiac surgey , pacemaker implantation , persistent left superior vena cava , sick sinus syndrome
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Department of Health Policy and Organization, Al-Farabi Kazakh National University, Almaty, Kazakhstan
Department of Interventional Cardiology and Arrhythmology, National Scientifi c Center of Surgery named after A.N. Syzganov, Almaty, Kazakhstan
Cardiovascular Center, University Clinic Schleswig-Holstein, Kiel, Germany
Consultative and Diagnostic Center, Research Institute of Cardiology and Internal Disease, Almaty, Kazakhstan
Department of Health Policy and Organization
Department of Interventional Cardiology and Arrhythmology
Cardiovascular Center
Consultative and Diagnostic Center
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