78-year-old man with a history of hypertension, diabetes mellitus and Parkinson's disease.
The patient was hospitalized for 2x1 atrioventricular block and paroxysmal complete atrioventricular block, with syncope, and definitive implant was indicated, opting for economic reasons due to ventricular septal defect V.
A left prepectoral subcutaneous pocket was made and the left axillary vein was punctured as usually performed in our laboratory, under radioscopic view during venography, which showed a persistent left superior vena cava dren.
By means of the 7 French active fixation electrode, the Saint Jude® model 1688T was advanced to the right atrium.
Then, the lead was advanced to the right ventricular outflow tract and positioned at the septo-infundibular level of the right ventricle, where a sensitive R wave of 8.0 mV Volt was obtained.
Absence of right superior vena cava was demonstrated by contrast injection in the right brachial vein.
The patient had no complications and was discharged after 24 h.
Subsequent follow-ups showed normal functioning of the bladder with adequate and stable parameters after one year.
