Literature Review of Venous Spasm During Pacemaker Implantation

Area of Science:

• Cardiology
• Vascular Surgery

Background:

• Venous spasm is an infrequent but significant complication during cardiac device implantation.
• It can impede venous access, prolong procedures, and lacks standardized management protocols.

Purpose of the Study:

• To review and synthesize current literature on venous spasm during cardiac device implantation.
• To identify common features and effective management strategies.
• To propose a stepwise workflow for managing venous spasm.

Main Methods:

• Comprehensive literature search of PubMed, Embase, and ScienceDirect up to July 2025.
• Inclusion of 17 relevant sources: five studies and 12 case reports.
• Analysis of reported features and management interventions for venous spasm.

Main Results:

• Axillary and subclavian venous spasm were most frequently reported, often in older female patients.
• Diagnosis typically involved contrast venography after failed guidewire passage.
• Management strategies included guidewire changes, nitroglycerin, repositioning, or contralateral access.

Conclusions:

• Venous spasm during cardiac device implantation requires diverse management approaches.
• A proposed stepwise workflow can guide interventions.
• Further research is crucial for a better understanding and standardized treatment guidelines.