Key result
Lead tunneling via the right internal jugular vein was successfully performed to place right atrial and right ventricular defibrillation leads in an 80-year-old man with bilateral subclavian vein occlusion.
Why the study?
Venous occlusion encountered during device upgrades can impede lead access to the myocardium despite various developed techniques to overcome this problem.
Case Report (n=1)
This case report and literature review highlights various techniques to overcome venous occlusion during cardiac device upgrades.
May inform lead access strategies in venous occlusion; leaves open need for prospective safety data.
Given increasing patient longevity and technological advances, including a greater availability of devices such as those used for cardiac resynchronization therapies, the number of patients needing device upgrades has been steadily rising. However, venous occlusion encountered at the time of new lead placement can impede lead access to the myocardium.1 Various techniques have been developed to overcome this problem, including full epicardial system, thoracoscopic or video-assisted implantation of leads, serial dilation, tunneled access, venoplasty, venous access proximal to the site of venous occlusion, and lead extraction.
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Khan et al. (2021) conducted a case report in Complete heart block, severe nonischemic cardiomyopathy, bilateral subclavian vein occlusion (n=1). Lead tunneling via right internal jugular vein was evaluated on Successful lead placement and device function. Lead tunneling via the right internal jugular vein was successfully performed to place right atrial and right ventricular defibrillation leads in an 80-year-old man with bilateral subclavian vein occlusion.
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