A case report of successful permanent pacemaker implantation via the iliac vein

Abstract An 85-year-old man was referred to our hospital with a pacemaker pocket infection. A permanent pacemaker had been implanted via the right subclavian vein. The pacemaker and pacing leads were removed and a temporary pacemaker was implanted. After vancomycin treatment for 4 weeks, pacemaker i...

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Bibliographic Details
Published in:Journal of arrhythmia 2016-04, Vol.32 (2), p.151-153
Main Authors: Yamaguchi, Tetsuo, MD, Miyamoto, Takamichi, MD, Yamauchi, Yasuteru, MD, Obayashi, Tohru, MD
Format: Article
Language:English
Subjects:
Cardiovascular
Case reports
Conflicts of interest
General anesthesia
Health aspects
Hematoma
Hip joint
Iliac vein
Local anesthesia
Methicillin
Ostomy
Pacemakers
Patients
Permanent pacemaker implantation
Pocket infection
Rapid Firing
Staphylococcus infections
Subclavian vein occlusion
Veins & arteries
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Summary:Abstract An 85-year-old man was referred to our hospital with a pacemaker pocket infection. A permanent pacemaker had been implanted via the right subclavian vein. The pacemaker and pacing leads were removed and a temporary pacemaker was implanted. After vancomycin treatment for 4 weeks, pacemaker implantation via the right external iliac vein was performed under local anesthesia because of left subclavian vein occlusion, infection of the right pocket, and difficulty with epicardial lead insertion. The iliac vein approach is an effective alternative in patients in whom the pectoral approach cannot be used. Learning objective : Permanent pacemaker implantation using the conventional pectoral approach is impossible or contraindicated in 1–6% of patients. In such patients, implantation via the iliac vein is considered an effective alternative. The advantages of this approach are that the wound size and bleeding amount are very small and that it can be performed under local anesthesia. Therefore, this approach can be used in patients with a poor general condition, including elderly patients.
ISSN:1880-4276
1883-2148
DOI:10.1016/j.joa.2015.08.004