Permanent pacing from a left ventricular vein in a patient with persistent left superior vena cava and absent right superior vena cava: use of an over-the-wire system.

In patients with a persistent left superior vena cava, placement of a permanent transvenous pacing lead for ventricular pacing via the left subclavian vein can be technically challenging. Permanent pacing was achieved in a patient with a persistent left superior vena cava and absent right superior vena cava using a left ventricular vein. Use of an over-the-wire lead system greatly facilitated this procedure.