Pacemaker implantation in a patient with a Behçet's disease associated with superior vena cava obstruction.
A 65-year-old man with Behçet's disease developed transient complete A-V block with syncope. An attempt to implant a permanent transvenous endocardial electrode failed owing to obstructions in the subclavian, innominate, and superior vena cava veins demonstrated by angiography. Sutureless epicardial electrodes were successfully implanted through a subxyphoid approach. Obstruction in the great veins is a common feature in patients with Behçet's disease. We suggest that patients with this disorder, who require a permanent pacemaker, should be investigated by angiography prior to implant to rule out obstruction in the upper great veins.
D000368:Aged; D001528:Behcet Syndrome / Q000150:complications*; D006327:Heart Block / Q000150:complications / Q000628:therapy*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D010138:Pacemaker, Artificial; D013479:Superior Vena Cava Syndrome / Q000209:etiology*