Treatment of pacemaker-induced superior vena cava syndrome by direct oral anticoagulant

Area of Science:

• Cardiology
• Vascular Medicine

Background:

• Cardiac implantable electronic devices (CIEDs) are increasingly used, leading to common lead-related vascular issues.
• Superior vena cava (SVC) syndrome is an uncommon but serious complication of pacemaker leads.
• Anticoagulation is standard for SVC syndrome, but data on direct oral anticoagulants (DOACs) are limited.

Purpose of the Study:

• To evaluate the efficacy of DOACs in managing SVC syndrome secondary to pacemaker leads.
• To present a case demonstrating the successful treatment of pacemaker-induced SVC syndrome with DOACs.

Main Methods:

• Case report of an 80-year-old male patient with SVC syndrome post-transvenous pacemaker implantation.
• Treatment with DOACs for four months to address obstructive symptoms.

Main Results:

• Significant relief of SVC syndrome obstruction symptoms observed after four months of DOAC therapy.
• Complete resolution of symptoms occurred within nine months of treatment initiation.

Conclusions:

• DOACs demonstrate effectiveness in treating SVC syndrome following pacemaker implantation.
• This represents a novel and potentially preferred treatment option for patients avoiding interventional procedures.