This case highlights the risk of acute lead insulation break (subclavian crush) when implanting multiple new leads during a device upgrade.
May warrant vigilance with multiple new leads during CRT-D upgrades; leaves open optimal prevention strategies.
A 71-year-old man with ischaemic cardiomyopathy had a dual-chamber pacemaker inserted via the subclavian vein for complete heart block. He was pacing dependent. Nine years later, he was upgraded to a cardiac resynchronization defibrillator. Three new leads were implanted …
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Tilling et al. (2014) studied this question.
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