Superior vena cava syndrome induced by endocardial defibrillator and pacemaker leads

Two cases of superior vena cava syndrome induced by endocardial defibrillator and pacemaker leads are described. The 2 patients had histories of multiple endocardial leads and device upgrades and venous thrombosis. The first patient was treated with laser lead extraction followed by percutaneous venoplasty and stenting. The second patient was treated conservatively with long-term anticoagulation. The 2 patients had symptomatic reduction. In conclusion, superior vena cava syndrome induced by transvenous leads is an uncommon but serious complication. Anticoagulation can be effective in select patients, but in severe cases, thrombolytic therapy or surgical or percutaneous intervention may be required. (c) 2007 Elsevier Inc. All rights reserved.