Dwa problemy jednej procedury CIED: spasm AV i supresja SV, a może „nie ma tego złego, co by na dobre nie wyszło”

Steckiewicz, Roman; Stolarz, Przemysław; Zieliński, Andrzej

doi:10.5603/fc.2021.0058

Folia Cardiologica

2021

DOI: 10.5603/fc.2021.0058

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Dwa problemy jednej procedury CIED: spasm AV i supresja SV, a może „nie ma tego złego, co by na dobre nie wyszło”

Roman Steckiewicz¹,

Przemysław Stolarz

Andrzej Zieliński³

Abstract: This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.Two problems during one pacemaker implantation procedure: axillary vein spasm and subclavian vein compression, or 'every cloud has a silver lining'Dwa problemy jednej procedury CIE… Show more

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2024

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Axillary and subclavian venous spasm during pacemaker implantation – A case report and literature review

Venet,

Vergier,

Cenac

et al. 2024

Clinical Case Reports

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Key Clinical MessageVenous spasm is an important reason for complicated or failed implantations of cardiac implantable electronic devices. Prevention or risk reduction of venous spasm during cardiac implantable electronic device implantation may be achieved by ultrasound or fluoroscopic imaging prior to puncture, cephalic vein cut‐down, sufficient pre‐ and perioperative hydration, nitroglycerin injection and effective sedation, and analgesia.AbstractThis case report with literature review focuses on venous spasm as a potential cause for complicated implantations of cardiac implantable electronic devices. The case report is clinically relevant as it describes a progressive spasm affecting the axillary and the subclavian vein. A 66‐year‐old female complained of symptomatic atrial fibrillation (AF) and atypical atrial flutter despite interventional and medical treatment. As an ultimate treatment, she was scheduled for pacemaker implantation and atrioventricular node ablation. Several puncture attempts of the axillary vein failed. Despite venous blood aspiration, no guidewires could be advanced into the axillary vein. We performed a first venogram revealing significant spasm of the axillary vein. Another failed venous puncture occurred after change of access site to the subclavian vein. A second venogram displayed progression of the spasm, now affecting both the axillary and the subclavian veins. Normal saline perfusion was administered as well as intravenous isosorbide. Unfortunately, a repeated venogram after 15 min waiting time showed persistence of the spasm, still affecting both veins. The procedure was discontinued as the patient became uncomfortable. Venous spasm is an important reason for complicated or failed implantations of cardiac implantable electronic devices. Commonly used medical prevention and treatment are intravenous fluids and nitroglycerin. Prevention or risk reduction of venous spasm during cardiac implantable electronic device implantation may be achieved by ultrasound or fluoroscopic imaging prior to puncture, cephalic vein cut‐down, sufficient pre‐ and perioperative hydration, nitroglycerin injection and effective sedation and analgesia.

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Axillary and subclavian venous spasm during pacemaker implantation – A case report and literature review

Venet,

Vergier,

Cenac

et al. 2024

Clinical Case Reports

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show abstract

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Dwa problemy jednej procedury CIED: spasm AV i supresja SV, a może „nie ma tego złego, co by na dobre nie wyszło”

Cited by 1 publication

References 8 publications

Axillary and subclavian venous spasm during pacemaker implantation – A case report and literature review

Axillary and subclavian venous spasm during pacemaker implantation – A case report and literature review

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