为左上腔静脉永存合并右上腔静脉缺如患者植入起搏导线

目的 对左上腔静脉永存合并右上腔静脉缺如患者的心室起搏导线植入方法作初步探讨，方法 为3例病态窦房结综合征，2例三度房室阻滞患者植入VVI起搏系统，导线经左上腔静脉、冠状静脉窦、右心房、三尖瓣口而固定于右心室心尖部（4例）或至心大静脉远段（1例），靠近心外膜左缘。结果 5例患者的导线均成功放置分别随访3个月-7年，起搏功能良好。结论 对左上腔静脉存伴右上腔静脉缺如患者植入心脏起搏系统，通过适当地操作，一般可将导线定侠于右心室心尖部；而经冠状静脉窦作左心室心外膜起搏亦是可以选择的。

Implantation of pacing lead in patients with persistent left superior vena cava and absent right superior vena cava

Objective As persistent left superior vena cava with absent right superior vena cava often causes difficulties in the diagnosis and treament of cardiovascular disease intervention,the implantation way of pacing lead in five patients with these anomaly was assessed. Methods Three of these patients suffered from sick sinus syndrome (SSS),and the other two cases were from complete AV block.The lead passed down the coronary sinus(CS)and right atrium through the PLSVC in 4 cases.After appropriate manipulation it was inserted into the apex of the right ventricle.The lead passed the CS and great cardiac vein via the PLSVC in another case.It was fixed against the epicardium of the left ventricular free wall. Results These patients were followed up for 3 months to 7 years.The pacing and sensing functions were normal in all patients. Conclusion By means of careful manipulation the lead may usually be inserted into the apex of the right ventricle via PLSVC;or the lead may also be fixed on the epicardium of the left ventriculer via CS and great cardiac vein.The later may be more suitable on physiologic point of view.