Persistent left superior vena cava (PLSVC) is a benign vascular anomaly that complicates pacemaker or implantable cardioverter defibrillator (ICD) lead implantation. Thus far, right ventricular lead implantation via PLSVC has been mostly accomplished by forming a U-shaped stylet, necessitating considerable manoeuvring depending on the heart size and geometry. In this article we report a technique of ICD lead implantation via PLSVC, using a coronary sinus delivery system as used today in cardiac resynchronization therapy.