Pneumothorax Resulting from Subclavian Puncture: a Complication of Permanent Pacemaker Lead Implantation

Overview

Journal Neth Heart J

Specialty Cardiology & Vascular Diseases

Date 2015 Feb 20

PMID 25696306

Citations 10

Authors

J C J Res

J A de Priester

A A van Lier

C L J M van Engelen

P N A Bronzwaer

P-H Tan

M Visser

Affiliations

Soon will be listed here.

Abstract

Pneumothorax is a mild complication during pacemaker lead implantation using the subclavian puncture technique. We report on five-year experience in 433 pacemaker lead implantation procedures in 379 patients. The cephalic vein route was solely used in twelve patients. Three procedures were performed over time in four patients and one patient needed four repetitive punctures for pacemaker lead implantation and replacement. Thus 421 punctures were carried out in 367 patients. Eleven case of pneumothorax were observed: in eight patients (1.9%) a partial pneumothorax occurred and in three patients (0.7%) the pneumothorax was nearly complete. In the latter patients a chest tube was inserted and hospital admission was prolonged for 3, 6 and 6 days, respectively. Old age with a corresponding abnormality in the form of chest deformation were predominantly found in the patients with this type of complication.

Citing Articles

Case report: A rare complication after the implantation of a cardiac implantable electronic device: Contralateral pneumothorax with pneumopericardium and pneumomediastinum.

Lo S, Chen J Front Cardiovasc Med. 2022; 9:938735.

PMID: 36061532 PMC: 9433779. DOI: 10.3389/fcvm.2022.938735.

Long-term in vivo operation of implanted cardiac nanogenerators in swine.

Li J, Hacker T, Wei H, Long Y, Yang F, Ni D Nano Energy. 2021; 90(Pt A).

PMID: 34737918 PMC: 8562697. DOI: 10.1016/j.nanoen.2021.106507.

Bilateral Pneumothorax Complicating Pacemaker Implantation, due to Puncture of the Left Subclavian Vein and Electrode Perforation of the Right Atrium.

Olesen L Cureus. 2020; 12(11):e11302.

PMID: 33282579 PMC: 7716385. DOI: 10.7759/cureus.11302.

Cardiac Implantable Electronic Miniaturized and Micro Devices.

Rav Acha M, Soifer E, Hasin T Micromachines (Basel). 2020; 11(10).

PMID: 33003460 PMC: 7600795. DOI: 10.3390/mi11100902.

Access times for supraclavicular and infraclavicular approaches of subclavian vein catheterization in pacemaker insertion.

Javed N, Malik J Int J Health Sci (Qassim). 2020; 14(3):14-17.

PMID: 32536844 PMC: 7269626.

References

Furman S . Venous cutdown for pacemaker implantation. Ann Thorac Surg. 1986; 41(4):438-9. DOI: 10.1016/s0003-4975(10)62705-1. View

Kiviniemi M, Pirnes M, Eranen H, Kettunen R, Hartikainen J . Complications related to permanent pacemaker therapy. Pacing Clin Electrophysiol. 1999; 22(5):711-20. DOI: 10.1111/j.1540-8159.1999.tb00534.x. View

Fyke 3rd F . Doppler guided extrathoracic introducer insertion. Pacing Clin Electrophysiol. 1995; 18(5 Pt 1):1017-21. DOI: 10.1111/j.1540-8159.1995.tb04742.x. View

Youmans Jr C, DERRICK J, Wallace J . Considerations of complications of permanent transvenous pacemakers. Am J Surg. 1967; 114(5):704-10. DOI: 10.1016/0002-9610(67)90133-x. View

Kessinger J, Holter A, Geha A . Implantation of permanent transvenous pacemaker via subclavian vein. Arch Surg. 1982; 117(8):1105-7. DOI: 10.1001/archsurg.1982.01380320087023. View

Belott P . A variation on the introducer technique for unlimited access to the subclavian vein. Pacing Clin Electrophysiol. 1981; 4(1):43-8. DOI: 10.1111/j.1540-8159.1981.tb03673.x. View

Miller Jr F, Holmes Jr D, Gersh B, Maloney J . Permanent transvenous pacemaker implantation via the subclavian vein. Mayo Clin Proc. 1980; 55(5):309-14. View

Tocino I, Miller M, Fairfax W . Distribution of pneumothorax in the supine and semirecumbent critically ill adult. AJR Am J Roentgenol. 1985; 144(5):901-5. DOI: 10.2214/ajr.144.5.901. View

Magney J, Parsons J, Flynn D, Hunter D . Pacemaker and defibrillator lead entrapment: case studies. Pacing Clin Electrophysiol. 1995; 18(8):1509-17. DOI: 10.1111/j.1540-8159.1995.tb06737.x. View

10.

Stone C, Aquilina T, Mangar D, FONTE A . Left infraclavicular brachial plexus block during pacemaker placement through the left subclavian vein. Anesth Analg. 1994; 78(3):602. DOI: 10.1213/00000539-199403000-00034. View

11.

Fiorista F, Lazari M, Marzegalli M, PIANE C, Cotti R, Casazza F . [Use of the subclavian vein for permanent cardiac stimulation]. Arch Inst Cardiol Mex. 1986; 56(4):309-13. View

12.

Zwirner K . [Insertion of permanent endocardial pacing electrodes through the subclavian vein: results of a five-year period (author's transl)]. Z Kardiol. 1980; 69(12):835-9. View

13.

Calkins H, Ramza B, Brinker J, Atiga W, Donahue K, Nsah E . Prospective randomized comparison of the safety and effectiveness of placement of endocardial pacemaker and defibrillator leads using the extrathoracic subclavian vein guided by contrast venography versus the cephalic approach. Pacing Clin Electrophysiol. 2001; 24(4 Pt 1):456-64. DOI: 10.1046/j.1460-9592.2001.00456.x. View

14.

Despars J, Sassoon C, Light R . Significance of iatrogenic pneumothoraces. Chest. 1994; 105(4):1147-50. DOI: 10.1378/chest.105.4.1147. View

15.

Shahian D, Venditti Jr F . Hemothorax associated with anticoagulation after placement of implantable cardioverter defibrillator: possible similarity to postinfarction Dressler's syndrome. Pacing Clin Electrophysiol. 1992; 15(9):1233-5. DOI: 10.1111/j.1540-8159.1992.tb03131.x. View

16.

Bernstein A, Parsonnet V . Survey of cardiac pacing in the United States in 1989. Am J Cardiol. 1992; 69(4):331-8. DOI: 10.1016/0002-9149(92)90229-r. View

17.

Littleford P, Parsonnet V, Spector S . Method for the rapid and atraumatic insertion of permanent endocardial pacemaker electrodes through the subclavian vein. Am J Cardiol. 1979; 43(5):980-2. DOI: 10.1016/0002-9149(79)90363-1. View

18.

BYRD C . Clinical experience with the extrathoracic introducer insertion technique. Pacing Clin Electrophysiol. 1993; 16(9):1781-4. DOI: 10.1111/j.1540-8159.1993.tb01810.x. View

19.

Hildick-Smith D, Lowe M, Newell S, Schofield P, Shapiro L, Stone D . Ventricular pacemaker upgrade: experience, complications and recommendations. Heart. 1998; 79(4):383-7. PMC: 1728671. DOI: 10.1136/hrt.79.4.383. View

20.

Bartecchi C . Bedside emergency transvenous cardiac pacing: experience in two community hospitals. JACEP. 1976; 5(3):169-73. DOI: 10.1016/s0361-1124(76)80338-3. View