Subclavian Crush Syndrome Complicationg Transvenous Pacemaker Implantaion

Objective To analyze major probable causes, and remedies of lead fracture due tosubclavian crush in implanted pacemaker.Methods From January 2004 to December 2005, on all the pacemakers implanted atthis hospital, lead fracture due to subclavian crush were detected timely by regulartelemetric programmed testing, chest radiography and electrocardiography.Appropriate remedial actions were given and follow up visits were done to verify theresults.Results Of all the 281 pacemakers and 4 ICDs, there were there were total 7fractures invovling 9 leads, all the 7 lead fractures among those pacemakers implantedby subclavian venipuncture. Fracture locations: 6 cases at the juncture of the clavicleand first rib, one between the first two ribs. All the patients were implanted withadditional new leads, the original ones was left embedded, In one patient, the lead wasremoved due to infection.Conclusions Among those pacemakers implanted by subclavian venipuncture,most lead fractures are detected at the region of medial subclavian. Regular follow-up,including regular telemetnc programmed testing, chest radiography and electrocardiography can help timely detect lead fracture, so that the cases can be dealt with properly.