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; Ana Bernardes; João de Sousa; Pedro Marques

doi:10.1016/j.ipej.2015.07.008

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

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

Authors

Miguel Nobre Menezes¹, Ana Bernardes¹, João de Sousa¹, Pedro Marques¹

Affiliation

¹ Cardiology Department, University Hospital Santa Maria, CHLN, Hospital de Santa Maria, Avenida Prof Egas Moniz, 1649-035 Lisbon, Portugal.

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.