title: Overcoming a subclavian complete occlusion: Simple single lead extraction by the subclavian vein allowing implantation of two new leads and upgrade to CRT-P with multi-site pacing.
abstract: Central venous obstruction following pacemaker implantation is not uncommon, and can prove challenging in the case of system upgrade. We report a case of DDDR to CRT-P (with multi-site pacing) upgrade, where a subclavian occlusion was overcome resorting to an atrial lead extraction (using only a locking stylet). This allowed regaining of the venous access with subsequent implantation of not just one, but two new leads and subsequent successful upgrade.
authors.affiliation: Cardiology Department, University Hospital Santa Maria, CHLN, Hospital de Santa Maria, Avenida Prof Egas Moniz, 1649-035 Lisbon, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Nobre Menezes
authors.affiliation: Cardiology Department, University Hospital Santa Maria, CHLN, Hospital de Santa Maria, Avenida Prof Egas Moniz, 1649-035 Lisbon, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Bernardes
authors.affiliation: Cardiology Department, University Hospital Santa Maria, CHLN, Hospital de Santa Maria, Avenida Prof Egas Moniz, 1649-035 Lisbon, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: de Sousa
authors.affiliation: Cardiology Department, University Hospital Santa Maria, CHLN, Hospital de Santa Maria, Avenida Prof Egas Moniz, 1649-035 Lisbon, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques
keywords: CRT; Lead Extraction; Venous occlusion