Venous Obstruction in Cardiac Rhythm Device Therapy

  • Joseph DonnellyEmail author
  • James Gabriels
  • Andrew Galmer
  • Jonathan Willner
  • Stuart Beldner
  • Laurence M. Epstein
  • Apoor Patel
Vascular Disease (M Weinberg, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Vascular Disease


Purpose of review

A variety of complex vascular pathologies arise following the implantation of electronic cardiac devices. Pacemaker and defibrillator lead insertion may cause proximal venous obstruction, resulting in symptomatic venous congestion and the compromise of potential future access sites for cardiac rhythm lead management.

Recent findings

Various innovative techniques to recanalize the vein and establish alternate venous access have been pioneered over the past few years.


A collaborative team of electrophysiologists and vascular specialists strategically integrate the patient’s vascular disease into the planning of electrophysiology procedures. When vascular complications occur after device implantation, the same team effectively manages both the resulting vascular sequelae and related cardiac rhythm device challenges. This review will outline the various vascular challenges related to device therapy and offer an effective strategy for their management.


Vascular disease Electronic cardiac devices Proximal venous obstruction Lead insertion 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Joseph Donnelly
    • 1
    Email author
  • James Gabriels
    • 1
  • Andrew Galmer
    • 1
  • Jonathan Willner
    • 1
  • Stuart Beldner
    • 1
  • Laurence M. Epstein
    • 1
  • Apoor Patel
    • 1
  1. 1.Department of CardiologyNorth Shore University HospitalManhassetUSA

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