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Discussion  Although implantation of pacemaker leads through a PLSVC constitutes a challenging procedure due to manoeuvring difficulties of the pacing leads into the cardiac chambers, in this particular case, the presence of PLSVC was beneficial because it meant that no leads were present in the true SVC, reducing the risk of occlusion and avoiding the need for lead extraction. © The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.Background Best timing for coronary revascularization i