Radiology of Cardiac Pacemakers and their Complications with Three Cases of Superior Vena Caval Obstruction

Abstract

Summary Benefits of the radiographic assessment of patients with cardiac pacemakers in normal and abnormal situations are outlined. Three patients with transvenous pacemakers who developed superior vena caval obstruction are described. These were all proven by angiography and a satisfactory outcome was obtained with anticoagulants and the development of a collateral circulation. With the frequent use of cardiac pacemakers, an awareness of such a complication should lead to its early diagnosis and treatment.

Managing Superior Vena Cava Syndrome as a Complication of Pacemaker Implantation: A Pooled Analysis of Clinical Practice

“…Based on the specified criteria, we identified 104 qualifying patients from 74 different publications, published from 1970 through 2009 (see Table S1) 1,2 , 4–76 . Of the 104 patients (55 men, 39 women, 10 unspecified), the mean age (±standard deviation) was 59 (±14) years old.…”

Venous Complications After Insertion of a Transvenous Pacemaker

“…49,50 Factors that predispose to pacemaker lead-induced superior vena cava syndrome include the presence of a severed yet retained functionless lead 20,49,51,52 and evidence of infection of the pacemaker generator and lead system. 15,33,35,36,46,49 Clinically, pacemaker lead-induced superior vena cava syndrome is characterized by edema of the face, neck, and upper extremities in conjunction with cyanosis, headache, impaired vision, conjunctival injection, and tautly distended fundal veins. Pulmonary embolization in association with pacemaker lead-induced superior vena cava syndrome is extremely rare but has been detected.i-" DIAGNOSIS Pacemaker lead-induced venous thrombosis may often be diagnosed on the basis of the history and the physical examination.…”