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Updated: May 11, 2026
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Published on: August 8, 2025
Ventricular lead dysfunction and subclavian vein stenosis: when problems come in pairs
Joana Guardado1, Vitor Hugo Pereira, Marina Fernandes
1Departamentos de Cardiologia e de Cirurgia Vascular do Centro Hospitalar do Alto Ave, Guimarães, Portugal.
Summary
Venous balloon angioplasty successfully treated severe subclavian vein stenosis, restoring access for cardiac device lead reimplantation. This safe procedure avoids complex interventions in patients with device complications.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Cardiac device implantation is increasing, leading to more device-related complications.
- Lead failure is a significant complication, increasing morbidity, mortality, and reintervention rates.
- Chronic venous stenosis or occlusion can impede lead passage, complicating revisions and upgrades.
Observation:
- A 65-year-old male experienced defibrillator lead malfunction and severe left subclavian vein stenosis post-cardiac resynchronization therapy.
- The stenosis, located at a previous implantation site, limited venous access.
- The patient had a "Sprint Fidelis" defibrillator lead.
Findings:
- Successful percutaneous balloon venoplasty was performed to address the severe left subclavian vein stenosis.
- The procedure restored adequate venous access.
- This enabled the reimplantation of the right ventricular lead.
Implications:
- Venous balloon angioplasty is a valuable and safe tool for managing venous stenosis in cardiac device patients.
- It can help avoid more complex and hazardous procedures during lead revisions or system upgrades.
- This technique offers a solution for patients with limited venous access due to chronic stenosis or occlusion.
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