Outcome and Management of Pacemaker-Induced Superior Vena Cava Syndrome

Hai Xia Fu, Xin Miao Huang, Li Zhong, Michael J. Osborn, Haraldur Bjarnason, Siva Mulpuru, Xian Xian Zhao, Paul Andrew Friedman, Yong-Mei Cha

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background We aimed to determine the long-term outcomes of percutaneous lead extraction and stent placement in patients with pacemaker-induced superior vena cava (SVC) syndrome. Methods The study retrospectively screened patients who underwent lead extraction followed by central vein stent implantation at Mayo Clinic (Rochester, MN, USA), from January 2005 to December 2012, to identify the patients with pacemaker-induced SVC syndrome. Demographic, clinical, and follow-up characteristics of those patients were collected from electronic medical records. Results Six cases were identified. The mean (standard deviation) age was 56 (15) years (male, 67%). All patients had permanent dual-chamber pacemakers, with a mean 11-year history of pacemaker placement. The entire device system was explanted in five patients; one patient had a 21-year-old pacemaker lead that could not be removed. Eight stents were implanted in six patients: five patients had one stent, one patient had three. A new pacemaker system was reimplanted through the stented vein in five patients. Technical success was achieved in all patients, without any complication. Symptoms rapidly resolved in all patients after stent deployment. The mean follow-up duration was 48 months (range, 10-100 months). Three patients remained symptom free. Reintervention with percutaneous balloon venoplasty was successful in three patients with symptom recurrence. Conclusion Percutaneous stent implantation after lead removal followed by reimplantation of leads is a feasible alternative therapy for pacemaker-induced SVC syndrome, although some cases may require repeat intervention.

Original languageEnglish (US)
Pages (from-to)1470-1476
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Volume37
Issue number11
DOIs
StatePublished - Nov 1 2014

Keywords

  • lead extraction
  • pacemaker
  • superior vena cava syndrome
  • venous stenting

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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