Abstract
A 55-year-old man with a persistent left and an absent right superior vena cava (SVC) underwent an atraumatic left-sided implantation via a large left cephalic vein of a dual-chamber implantable-cardioverter defibrillator (ICD) with a 7.8F Biotronik 75/18 (Linox SD) active fixation ICD lead in 2008. In 2011, during coronary angiography prior to planned upgrade to a biventricular device, high-voltage conductors were observed outside of the expected lead envelope on fluoroscopy ( Figure 1A ). There was …
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