Use of a coronary sinus guiding sheath for placement of right ventricular lead in abnormal venous anatomy: a report of 2 cases.

Techniques of implanting pacing leads in the right ventricle (RV) have evolved over time and involve the use of preshaped stylets. However, in the presence of venous abnormalities, it could be very challenging to do the same. We describe two cases with complex superior vena caval (SVC) anatomy which could be negotiated only with the use of a slittable coronary sinus guiding sheath and successful placement of pacing lead in the right ventricle.