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. 2015 Jul 29;15(2):118-20.
doi: 10.1016/j.ipej.2015.07.008. eCollection 2015 Mar-Apr.

Overcoming a subclavian complete occlusion: Simple single lead extraction by the subclavian vein allowing implantation of two new leads and upgrade to CRT-P with multi-site pacing

Miguel Nobre Menezes  1 , Ana Bernardes  1 , João de Sousa  1 , Pedro Marques  1
Affiliations

Overcoming a subclavian complete occlusion: Simple single lead extraction by the subclavian vein allowing implantation of two new leads and upgrade to CRT-P with multi-site pacing

Miguel Nobre Menezes et al. Indian Pacing Electrophysiol J. .

Abstract

Central venous obstruction following pacemaker implantation is not uncommon, and can prove challenging in the case of system upgrade. We report a case of DDDR to CRT-P (with multi-site pacing) upgrade, where a subclavian occlusion was overcome resorting to an atrial lead extraction (using only a locking stylet). This allowed regaining of the venous access with subsequent implantation of not just one, but two new leads and subsequent successful upgrade.

Keywords: CRT; Lead Extraction; Venous occlusion.

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Figures

Fig. 1
Fig. 1
Contrast venography depicting subclavian obstruction.
Fig. 2
Fig. 2
Passage of a guidewire through introducer after extraction of the atrial catheter.
Fig. 3
Fig. 3
Final catheter position just before connecting to the generator.
See this image and copyright information in PMC

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