Advances in Interventional Cardiology
eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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abstract:
Original paper

Use of Doppler ultrasound in diagnosing pacemakerrelated subclavian vein occlusion following biventricular pacemaker replacement

Ayse S. Koc
1
,
İlkyaz Yogruk
1
,
Mustafa L. Ardıç
2
,
Hazar Harbalıoğlu
2
,
Hilmi E. Sumbul
3
,
Hasan Koca
2
,
Abdullah E. Çetin
2
,
Mevlut Koc
2

  1. Department of Radiology, University of Health Sciences – Adana Health Practices and Research Center, Adana, Turkey
  2. Department of Cardiology, University of Health Sciences – Adana Health Practice and Research Center, Adana, Turkey
  3. Department of Internal Medicine, University of Health Sciences – Adana Health Practice and Research Center, Adana, Turkey
Adv Interv Cardiol
DOI: https://doi.org/10.5114/aic.2025.156290
Online publish date: 2025/11/18
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Introduction
Subclavian vein occlusion (SVO) is a common complication following pacemaker implantation.

Aim
The study aimed to determine the long-term incidence of SVO following cardiac resynchronization therapy (CRT) implantation using venous Doppler ultrasonography (USG).

Material and methods
This cross-sectional study included 181 patients who underwent CRT implantation and were due for elective battery replacement. Patients in whom venous Doppler USG examination did not reveal subclavian vein flow were pre-diagnosed with SVO. A definitive diagnosis of SVO was made in patients who were pre-diagnosed with SVO using venography on the day of CRT battery replacement. Patients were divided into two groups as patients with and without SVO.

Results
A definitive SVO diagnosis was made in 59 (33%) patients. Patients with SVO were significantly older, were more likely to have hypertension and diabetes mellitus (DM), and had longer duration of CRT implantation than patients without SVO. Venous Doppler USG examination revealed that the respirophasic flow disappeared in all patients with SVO, a continuous flow pattern was present, and the axillary vein flow velocity was significantly lower compared to patients without SVO. Variables found to be significantly associated with SVO in univariate analysis were further evaluated using multivariate logistic regression analysis. Consequently, DM and advanced age were found to be independent variables significantly predicting SVO (p < 0.05 for each case).

Conclusions
Approximately one-third of our sample was diagnosed with definitive SVO in the long term after CRT implantation. Venous Doppler USG is a useful, simple and non-invasive method that can be used for the preliminary diagnosis of SVO.

keywords:

subclavian vein occlusion, Doppler ultrasonography, cardiac resynchronization therapy
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