The case of 65-year-old male patient who underwent DDD pacemaker implantation due to symptomatic tachy-brady syndrome with first degree AV block is presented. During the procedure a paroxysmal atrial fibrillation occured and the presence of persistent left superior vena cava (PLSVC) was diagnosed. The "straight" passive fixation leads were introduced through the PLSVC and placed in the right atrium and ventricle, using curved stylets. Atrial lead implantation during atrial fibrillation is discussed. At three month, a follow-up revealed normal DDD pacemaker function.