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Two patients underwent permanent endocardial pacing for complete atrioventricular block. In each case a persistent left superior vena cava was either suspected or known to be present. An active fixation electrode was passed down the left superior vena cava and the tip positioned in the apex of the right ventricle. Stable ventricular pacing was achieved for the follow-up period of approximately six months. With the availability of such active fixation electrodes the presence of a persistent left superior vena cava no longer mandates insertion of an endocardial electrode via the right superior vena cava, when present, or implantation of an epicardial pacing system.
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