Pacemaker leads in right and left superior vena cavae
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Biventricular pacemaker or more correctly implantable cardioverter-defibrillator (CRT-D) with the right atrial and right ventricular leads appropriately positioned via a right superior vena cava and the left ventricular lead appropriately positioned in the coronary sinus via a left superior vena cava. Small left pneumothorax, trace right pleural effusion.
A left superior vena cava is present in <1% of the population but in most people is accompanied by a right superior vena cava as in this case.