Outcome and Management of Pacemaker‐Induced Superior Vena Cava Syndrome

Abstract

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.

A Review of Open and Endovascular Treatment of Superior Vena Cava Syndrome of Benign Aetiology

“…When a pacemaker was present two approaches were adopted: the first consisted of lead removal, stent implantation, and reimplantation of new leads. 8 The leads were removed by manual traction or with an excimer laser if traction was unsuccessful. 8 The second approach was plain balloon dilatation of the vein with stent placement in selected cases.…”

Change from Cardioinhibitory Syncope to Iatrogenic Positional Syncope: Superior Vena Cava Syndrome Treated by Superior Vena Cava Stenting and Leadless Pacemaker Implantation

“…Reintervention with percutaneous balloon venoplasty is successful in most patients with symptom recurrence. 7 However, the use of a leadless pacemaker to treat neurocardiogenic syncope, while uncommon, has been increasingly reported in the literature. 8,9 Furthermore, although successful results have been shared with respect to for stenting of the SVC with the leads in place, 10 concerns persist with regard to the potential risk of lead damage and ensuing dysfunction caused by the metallic mesh of the stent.…”

“…In addition, entrapment of pacemaker leads by a stent would make potential future extraction of the leads (eg, for infection) virtually impossible without a cardiac surgical procedure. 7 The implantation of a leadless pacemaker eliminates important sources of complications associated with traditional pacing systems, such as lead failure, pocket complications, and infection, while providing similar pacing performance and potentially better psychological and aesthetic results. 9 As such, the leadless pacemaker may be an effective alternative method in the treatment of recurrent neurocardiogenic syncope.…”

Stent use for hemodialysis access: What a general nephrologist needs to know

“…40 A retrospective review of 36 hemodialysis patients who underwent vascular access creation, the primary access failure for AVF created ipsilateral to an existing IECD was 78.9% versus 35.3% those created on the contralateral side. 44,45 The development of epicardial leads or leadless pacemaker and subcutaneous defibrillators will hopefully mitigate this problem in the future. The decision process with central vein stenosis in presence of ipsilateral IECD can be complex.…”

“…Alternatively, ligating the dialysis access and creating a new vascular access on the contralateral side may be simpler solution, if feasible. 44,45 The development of epicardial leads or leadless pacemaker and subcutaneous defibrillators will hopefully mitigate this problem in the future. 46…”