Subclavian Venous Spasm During Pacemaker Implantation: A Case Report

We present the case of an 88-year-old female who presented to the cardiologist's clinic with symptoms of palpitations, dizziness, and fatigue. After cardiac monitoring, the patient was diagnosed with symptomatic bradycardia and required a pacemaker. During the pacemaker implantation procedure, attempts to access the subclavian vein were unsuccessful, and venography revealed severe venous spasm. The spasm did not relieve with time or nitroglycerin. Eventually, a leadless pacemaker was successfully implanted. We propose leadless pacemaker implantation as a viable management strategy for refractory venous spasm that avoids the risks of contralateral access.