Key result
Atrial lead extraction using a locking stylet successfully overcame a subclavian complete occlusion, allowing venous access for the implantation of two new leads and upgrade to CRT-P.
Case Report (n=1)
Atrial lead extraction using a locking stylet can be a viable technique to regain venous access in patients with subclavian complete occlusion requiring pacemaker upgrade.
May enable venous access restoration for CRT upgrade via atrial lead extraction; hypothesis-generating and requires prospective validation.
Central venous obstruction following pacemaker implantation is not uncommon, and can prove challenging in the case of system upgrade. We report a case of DDDR to CRT-P (with multi-site pacing) upgrade, where a subclavian occlusion was overcome resorting to an atrial lead extraction (using only a locking stylet). This allowed regaining of the venous access with subsequent implantation of not just one, but two new leads and subsequent successful upgrade.
No takes yet. Share an insight, caveat, or question.
Menezes et al. (2015) conducted a case report in Subclavian complete occlusion following pacemaker implantation (n=1). Atrial lead extraction using a locking stylet was evaluated on Regaining venous access and successful implantation of new leads. Atrial lead extraction using a locking stylet successfully overcame a subclavian complete occlusion, allowing venous access for the implantation of two new leads and upgrade to CRT-P.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: