Bi-atrial subxiphoid epicardial pacemaker in superior vena cava syndrome.
A patient with a bi-atrial-ventricular permanent pacemaker due to paroxystic atrial fibrillation associated to sinus bradycardia, in chronic use of oral anticoagulant, presented clinical signs of superior vena cava syndrome. Digital subtraction venography showed total obstruction of the right brachiocephalic venous trunk and severe stenosis of the connection of the left trunk to the superior vena cava. The therapeutic approach consisted of complete removal of transvenous system followed by re-implant of the bi-atrial-ventricular system using an epicardial subxiphoid access with fluoroscopic assistance.
Costa
Roberto
R
Instituto do Coração, Hospital das Clínicas, FM, USP, São Paulo, SP, Brazil. rcosta@cardiol.br
Leão
Maria Inês de Paula
MI
Silva
Kátia Regina da
KR
Camargo
Paulo Roberto
PR
Costa
Regina Valéria
RV
D000368:Aged; D020878:Device Removal / Q000379:methods; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D010496:Pericardium; D012086:Reoperation; D013479:Superior Vena Cava Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy