Key result
Subclavian crush syndrome causes intermittent pacemaker malfunction and cardiac arrest requiring lead replacement.
Why the study?
Subclavian vein access for CIED implantation has several potential complications, including late complications like subclavian crush syndrome.
Case Report (n=1)
No
Subclavian crush syndrome is a late complication of subclavian vein access that can cause intermittent loss of pacemaker output and syncope, which can be acutely managed by changing lead polarity prior to lead replacement.
Subclavian crush warrants consideration in unexplained pacemaker syncope; case leaves open optimal access-site strategies and surveillance.
Subclavian vein access is still one of the most favoured access options for cardiac implantable electronic device (CIED) implantation. For the physician, the technique is reasonably familiar and easy to carry out. However, this has several potential complications. In this case, we present a late complication of subclavian access. The patient presented with intermittent loss of pacemaker output, which caused him to experience several syncopal events. In the acute setting, we changed the lead polarity and achieved a good outcome. Further management of this situation consisted of removal and replacement of the damaged lead. LEARNING POINTS: Subclavian vein access is still one of the most favoured access options for cardiac device implantation.Intermittent loss of output can be a sign of pacemaker malfunction due to subclavian crush syndrome.Damaged lead extraction may be difficult to perform.
No takes yet. Share an insight, caveat, or question.
Rizal et al. (2020) conducted a case report in Subclavian crush syndrome (n=1). Lead replacement and polarity change was evaluated. A 69-year-old male experienced recurrent syncope and cardiac arrest due to intermittent pacemaker malfunction caused by subclavian crush syndrome, necessitating lead replacement.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: