Sinus arrest following angioplasty and stenting for superior vena cava syndrome.
Superior vena cava (SVC) syndrome is a complication resulting from long-term residence of leads or in-dwelling catheters at the SVC to right atrial (RA) junction. SVC syndrome management is complicated by variable responses to anticoagulation therapies and technically challenging interventional procedures, such as balloon dilatation or stent placement at the SVC-RA junction to relieve blood-flow obstruction. Potential complications resulting from angioplasty/stenting for SVC syndrome are serious and include stent migration, major bleeding, and embolism. Bradyarrhythmias have not been reported. We describe a case of balloon angioplasty and stenting for SVC syndrome in a dialysis patient that resulted in sinus arrest. The complication developed within hours of angioplasty/stenting of her chronic, non-thrombotic SVC obstruction. We highlight the management approach to this patient and discuss potential mechanisms underlying the complication.
Northwestern University, 251 East Huron Street, Feinberg 08-503, Chicago, IL 60611 USA. l-ilkhanoff@northwestern.edu.
Michael
M
Tempelhof
Joseph
J
Campbell
Leonard
L
Ilkhanoff
D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D002316:Cardiotonic Agents / Q000627:therapeutic use; D004298:Dopamine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D054138:Sinus Arrest, Cardiac / Q000188:drug therapy / Q000209:etiology*; D015607:Stents / Q000009:adverse effects*; D013479:Superior Vena Cava Syndrome / Q000628:therapy*; D016896:Treatment Outcome
D002316:Cardiotonic Agents; D004298:Dopamine