Successful Treatment of Superior Vena Cava Syndrome Induced by Transvenous Permanent Pacemaker Implantation with Balloon Angioplasty

Superior vena cava (SVC) syndrome is a rare but potentially lethal complication of transvenous permanent pacemaker implantation. The pathogenesis is unclear, but thrombosis and fibrotic constriction of the vessels are believed to be responsible for this situation. Multiple, severed, and previously infected leads may increase the risk of SVC syndrome, but are not prerequisite for it. Anticoagulation, thrombolytics, percutaneous balloon angioplasty with or without stent, and surgery have been used to solve the problem. We report a case who developed SVC syndrome three years after the implantation of a DDD pacemaker for sick sinus syndrome. Anticoagulation alone failed to relieve his symptoms. After successful balloon angioplasty, the patient remained asymptomatic one year after the procedure.