Background: The number of patients who depend on pacemaker (PM) insertion is steadily increasing. Slovenia has two centers for PM insertion, in which 250 such procedures are performed every year. Thus, with regard to the number of procedures per year per million inhabitants, Slovenia holds a middle position in the list of countries.
Method: We report a patient with cardiomyopathy, complete A-V block (A-V block III) and permanent transvenous pacing lead replacements. The resulting thrombosis of the superior vena cava compelled us to insert an epicardial permanent pacing lead. Video-assisted thoracic surgery (VATS) technique was selected.
Results: Surgery was safe for the patient, of 40 minutes' duration, and with minimum blood loss. The postoperative course was devoid of complications, the patient's circulation was stable, and he was able to leave the hospital one week later.
Conclusions: We believe that the choice of the thoracoscopic method of epicardial permanent pacing lead insertion is appropriate, and that the method is safe and promising as it broadens the indications for the VATS technique.