Arrhythmias & electrophysiology
Managing superior vena cava syndrome in patients with cardiac implantable electronic device leads: Strategies and considerations
Authors' conclusion
Lead-related SVC syndrome management requires a multidisciplinary approach often including TLE followed by angioplasty and stenting.
Study context
- Population
- Patients with transvenous (TV) lead-associated superior vena cava (SVC) syndrome, Emory Healthcare, 2015–2023
- Participants
- 15 patients
- Exposure
- Reimplantation vs No reimplantation
- Reimplantationn = 7
- No reimplantationn = 5reference
- Outcome
- Management and outcome of lead-related SVC syndrome
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Mean age (years)
- 50
- Swelling of face, neck and upper extremities
- 67%
- Shortness of breath
- 53%
- Lightheadedness
- 40%
- Leads crossing the SVC (mean ± SD)
- 2 ± 0.7
- Lead dwell time (years)
- 9.8 ± 7.5
- Managed with transvenous lead extraction (TLE)
- 13
- TLE then SVC stenting and angioplasty
- 10
- TLE then angioplasty alone
- 2
- TLE without further intervention
- 1
- Anticoagulation only
- 1
- Angioplasty and stenting with lead jailing
- 1
Observational data: associations, not effects.
Further findings
Events
| Outcome | Reimplantation | No reimplantation |
|---|---|---|
| Symptom recurrence after TLE and angioplasty ± stenting (n = 12) | 2 | 0 |
Safety
SVC perforation and cardiac tamponade during SVC stenting
- Patients with SVC perforation and tamponade, managed successfully with covered stent and pericardiocentesis
- 1
Original publication
Managing superior vena cava syndrome in patients with cardiac implantable electronic device leads: Strategies and considerations. Heart Rhythm. Published 3 July 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →