IMPLANTATION OF PERMANENT PACEMAKER IN A PATIENT WITH SUPERIOR VENA CAVA OCCLUSION

Objective: Permanent pacemaker implantation via Ilium vena -inferior vena cava approach was used for patient with superior vena cava occlusion who is not suitable for a superior vena cava approach. Methods: A punctured of external iliac vein under the guidance of ultrasound, and placement of guide wire to inferior vena cava. There was no arteriovenous shunt by color-Doppler ultrasound and enhanced ultrasonography with 6-sf6. Under X-ray, the extra-long guide wire and the sheath were inserted, and the pacemaker electrode was placed along the sheath. The X-ray image showed that the position of the electrode tip was good. Removed the electrode wire, and fixed electrode. Extended incision and inserted the single chamber pacemaker,then sutured. Results: The parameters of pacemaker was good, and the incision healed well. Pacing checks post procedure during subsequent 2 weeks and 4 weeks follow-up were satisfactory. Conclusion: For cases which permanent pacemaker implantation cannot be performed through superior vena cava approach, implantation of the permanent pacemaker via external iliac vein-inferior vena cava approach could be a potential feasible option.