Most of the time implanting a pacemaker is run of the mill job for many of Interventional Cardiologists.
But at times it may throw up surprise unlike any other,

Here’s this patient with repeated syncope, Complete heart Block, having Left Sided SVC with grossly dilated Coronary sinus and aberrant Inferior Vena Cava. Very difficult to access Right Ventricle in such aberrant anatomy. Putting in Temporary pacemaker wasn’t possible.

One option was to definitely send patient to surgeon for epicardial pacemaker.

As patient’s relative gave their nod to proceed , did LSVC pacing and lead could be placed in RVOT in stead of RV apex.

Patient is now discharged with Normal pacing function.

By Gods grace , taking the risk and going with procedure paid off in stead of sending the pt to Surgeon.
But yes , still scratching my head over the anatomy. 😇😇😇

On right hand side is a pacemaker in a patient with normal anatomy. No 1 cardiologist in kolkata | Best cardiologist in kolkata | Best heart specialist in kolkata