Intermittent Pacemaker Malfunction Caused by Continuous Compression of the Lead by the Clavicle (Subclavian Crush Syndrome)
  • Ardian Rizal
    Arrhythmia and Pacing Division, Cardiology and Vascular Medicine, Universitas Brawijaya, Saiful Anwar General Hospital, Indonesia
  • Evit Ruspiono
    Catheterization Laboratory, Dr Iskak Tulungagung General Hospital, Indonesia
  • Dinarsari Hayuning Putri
    Cardiology Department, Ansari Saleh General Hospital Banjarmasin, Indonesia

Keywords

Pacemaker malfunction, subclavian crush syndrome

Abstract

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.

VIEW THE ENTIRE ARTICLE

References

  • Business Insider [Internet]. The 11 most implanted medical devices in America. Available from: https://www.businessinsider.com/the-11-most-implanted-medical-devices-in-america-2011-7 (accessed 5 March 2020).

  • Wilkoff BL, Auricchio A, Brugada J, Cowie M, Ellenbogen KA, Gillis AM, et al. HRS/EHRA Expert Consensus on the Monitoring of Cardiovascular Implantable Electronic Devices (CIEDs): description of techniques, indications, personnel, frequency and ethical considerations: developed in partnership with the Heart Rhythm Society (HRS) and the European Heart Rhythm Association (EHRA); and in collaboration with the American College of Cardiology (ACC), the American Heart Association (AHA), the European Society of Cardiology (ESC), the Heart Failure Association of ESC (HFA), and the Heart Failure Society of America (HFSA). Endorsed by the Heart Rhythm Society, the European Heart Rhythm Association (a registered branch of the ESC), the American College of Cardiology, the American Heart Association. Europace 2008;10(6):707–725.

  • Bongiorni MG, Proclemer A, Dobreanu D, Marinskis G, Pison L, Blomstrom-Lundqvist C, et al. Preferred tools and techniques for implantation of cardiac electronic devices in Europe: results of the European Heart Rhythm Association survey. Europace 2013;15(11):1664–1668.

  • Kotsakou M, Kioumis I, Lazaridis G, Pitsiou G, Lampaki S, Papaiwannou A, et al. Pacemaker insertion. Ann Transl Med 2015;3(3):42.

  • Sharma G, Senguttuvan NB, Thachil A, Leong D, Naik N, Yadav R, et al. A comparison of lead placement through the subclavian vein technique with fluoroscopy-guided axillary vein technique for permanent pacemaker insertion. Can J Cardiol 2012;28(5):542–546.

  • Chan NY, Kwong NP, Cheong AP. Venous access and long-term pacemaker lead failure: comparing contrast-guided axillary vein puncture with subclavian puncture and cephalic cutdown. Europace 2017;19(7):1193–1197.

  • Gallik DM, Ben-Zur UM, Gross JN, Furman S. Lead fracture in cephalic versus subclavian approach with transvenous implantable cardioverter defibrillator systems. Pacing Clin Electrophysiol 1996;19(7):1089–1094.

  • Bass D, Stephenson K, Gyi R, Zeltser R, Makaryus A. Subclavian crush syndrome: a rare cause of symptomatic bradycardia in a patient with a permanent pacemaker. J Cardiovasc Dis Diagn 2017;5(3):267.

  • Koneru JN, Kaszala K, Huizar JF, Ellenbogen KA. Lead fracture: incidence, diagnosis and preventing inappropriate ICD therapy. Card Electrophysiol Clin 2011;3(3):409–420.

  • Krahn AD, Morissette J, Lahm R, Haddad T, Baxter WW, McVenes R, et al. Radiographic predictors of lead conductor fracture. Circ Arrhythm Electrophysiol 2014;7(6):1070–1077.

  • Maytin M, Epstein LM, Henrikson CA. Lead extraction is preferred for lead revisions and system upgrades: when less is more. Circ Arrhythm Electrophysiol 2010;3(4):413–424 (discussion 424).

  • Bongiorni MG, Burri H, Deharo JC, Starck C, Kennergren C, Saghy L, et al. 2018 EHRA expert consensus statement on lead extraction: recommendations on definitions, endpoints, research trial design, and data collection requirements for clinical scientific studies and registries: endorsed by APHRS/HRS/LAHRS. Europace 2018;20(7):1217.

  • Bongiorni MG, Kennergren C, Butter C, Deharo JC, Kutarski A, Rinaldi CA, et al. The European Lead Extraction ConTRolled (ELECTRa) study: a European Heart Rhythm Association (EHRA) Registry of Transvenous Lead Extraction Outcomes. Eur Heart J 2017;38(40):2995–3005.
  • Views: 585
    HTML downloads: 436
    PDF downloads: 277


    Published: 2020-05-27
    Issue: 2020: Vol 7 No 8 (view)


    How to cite:
    1.
    Rizal A, Ruspiono E, Putri DH. Intermittent Pacemaker Malfunction Caused by Continuous Compression of the Lead by the Clavicle (Subclavian Crush Syndrome). EJCRIM 2020;7 doi:10.12890/2020_001684.