Prinzmetal angina in the migraine's aura resolving with headache.

bifascicular block (RBBB + LAFB). Interrupted episodes of complete paroxysmal AV block were detected during electrocardiographic monitoring on the ward. Echocardiography showed mild left ventricular systolic dysfunction with inferior akinesis. During implantation of a two-chamber permanent pacemaker via the left axillary vein, we observed LSVC persistence, the characteristics of which were similar to those described in the previous case. Two active fixation leads with distal electrodes were implanted in RA and RVOT, using manually preformed curved stylets identical to those described in case 1. No dislocations or changes in the stimulation parameters were observed during follow-up. Persistent LSVC can make implantation of a permanent pacemaker difficult. The fact that the coronary sinus ostium is not aligned with the tricuspid annulus means that the main technical problem consists of inserting the lead in the RV. The RVA has been the site of choice for cardiac stimulation, but reaching it in these cases usually means that the probe electrode forms a big loop in the RA. Stimulation in the RVOT has been proposed as an alternative to RVA stimulation. In terms of lead stability, it has shown similar long-term results to those achieved with stimulation at the apex,