The natural history of trifascicular disease following permanent pacemaker implantation. Significance of continuing changes in atrioventricular conduction.

Abstract Background Subclavian venous spasm is an uncommon complication during permanent pacemaker implantation. The exact aetiology of subclavian venous spasm is not clear but has been suggested to be due to either mechanical irritation of the vein during needle puncture or due to chemical irritation from contrast injection. Here, we report a case of an unyielding subclavian vein valve that impeded guidewire advancement and the repeated guidewire manipulation led to venous spasm. Case summary A 45-year-old woman with a history of surgical repair of Tetrology of Fallot in childhood presented with symptomatic bifascicular block and underwent a permanent pacemaker implantation. A subclavian venogram done prior to the procedure showed a prominent valve in the distal portion of the vein. Following venous puncture, guidewire advancement was impeded by the prominent valve. The resulting guidewire manipulation led to subclavian venous spasm necessitating a medial subclavian venous puncture and access. Discussion Prolonged mechanical irritation of the vein during pacemaker implantation may lead to venous spasm impeding pacemaker implantation. Early identification of an impeding valve and obtaining access medial to the valve may help prevent this uncommon complication.

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Permanent Pacemaker Implantation in a Patient with Takotsubo Cardiomyopathy and Complete Atrioventricular Block

Case Reports in Cardiology ◽

10.1155/2021/6637720 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Toshihiro Terui ◽

Masumi Iwai-Takano ◽

Tomoyuki Watanabe

Keyword(s):

Takotsubo Cardiomyopathy ◽

Wall Motion ◽

Pacemaker Implantation ◽

Left Ventricular ◽

Permanent Pacemaker ◽

Av Block ◽

Permanent Pacemaker Implantation ◽

History Of ◽

Complete Atrioventricular ◽

Complete Av Block

This case report presents a patient with Takotsubo cardiomyopathy (TCM) and complete atrioventricular (AV) block who was treated with permanent pacemaker implantation. A 78-year-old woman with a history of hypertension presented with a 6-month history of palpitations. On initial evaluation, her heart rate was 40 beats/minute. Electrocardiography revealed a complete AV block and T-wave inversion in these leads: I, II, aVL, aVF, and V3–6. Echocardiography showed akinesis from the midventricle to the apex and hyperkinesis on the basal segments. The patient was diagnosed with TCM and complete AV block. Because improvement of TCM may subsequently improve the AV node dysfunction associated with TCM, the patient was admitted for treatment of heart failure without pacemaker implantation. The left ventricular (LV) abnormal wall motion improved gradually; however, the AV block persisted intermittently. On hospital day 14, a pause of 5–6 seconds without LV contraction was observed, and permanent pacemaker implantation was performed. On day 92, echocardiography revealed normal LV wall motion. However, electrocardiography revealed that the pacemaker rhythm with atrial sensing and ventricular pacing remained. Although specific degree of damage that may result from AV block associated with TCM is unknown, some of these patients require pacemaker implantation, despite improvement of abnormality in LV wall motion.

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Dragoljub (Bata) Adamov (1927-1996): The first pacemaker implantation in Serbia

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh171122098p ◽

2017 ◽

Vol 145 (5-6) ◽

pp. 315-318

Author(s):

Sinisa Pavlovic

Keyword(s):

General Anesthesia ◽

History Of Medicine ◽

Pacemaker Implantation ◽

Permanent Pacemaker ◽

Former Yugoslavia ◽

Pacemaker Therapy ◽

Clinical Hospital ◽

Permanent Pacemaker Implantation ◽

History Of

It has been over half a century since the implementation of pacemaker therapy in our country and the region. The first successful implantation of a pacemaker in former Yugoslavia and in Serbia took place on September 16, 1965 in ?Dr. Dragisa Misovic? Clinical Hospital Centre, and this operation, with a team of doctors of the institution, was performed by surgeon Dragoljub (Bata) Adamov (1927?1996). The first permanent pacemaker implantation was with epicardial leads with thoracotomy approach. The patient was operated on under general anesthesia, administered by anesthesiologist Predrag Lalevic (1927?), and Dr. Adamov was assisted by Dr. Misa Albrecht (1933?) and Dr. Milan Dragovic (1933?2009). Although pacemaker therapy has since been widely proven and confirmed, it is necessary to remember the pioneers who introduced this kind of therapy to the region, as they deserve a distinguished place in the history of medicine in Serbia.

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