{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T07:11:53Z","timestamp":1761808313929,"version":"3.37.3"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2019,9,28]],"date-time":"2019-09-28T00:00:00Z","timestamp":1569628800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Subclavian venous spasm is an uncommon complication during permanent pacemaker implantation. The exact aetiology of subclavian venous spasm is not clear but has been suggested to be due to either mechanical irritation of the vein during needle puncture or due to chemical irritation from contrast injection. Here, we report a case of an unyielding subclavian vein valve that impeded guidewire advancement and the repeated guidewire manipulation led to venous spasm.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 45-year-old woman with a history of surgical repair of Tetrology of Fallot in childhood presented with symptomatic bifascicular block and underwent a permanent pacemaker implantation. A subclavian venogram done prior to the procedure showed a prominent valve in the distal portion of the vein. Following venous puncture, guidewire advancement was impeded by the prominent valve. The resulting guidewire manipulation led to subclavian venous spasm necessitating a medial subclavian venous puncture and access.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Prolonged mechanical irritation of the vein during pacemaker implantation may lead to venous spasm impeding pacemaker implantation. Early identification of an impeding valve and obtaining access medial to the valve may help prevent this uncommon complication.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytz142","type":"journal-article","created":{"date-parts":[[2019,9,28]],"date-time":"2019-09-28T05:32:16Z","timestamp":1569648736000},"page":"1-4","source":"Crossref","is-referenced-by-count":5,"title":["An unyielding valve leading to venous spasm during pacemaker implantation: a case report"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2278-4136","authenticated-orcid":false,"given":"Darshan","family":"Krishnappa","sequence":"first","affiliation":[{"name":"Cardiovascular Division, Variety Club Research Centre, University of Minnesota, 401 East River Parkway, 2nd Floor, Minneapolis, MN 55455, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5064-1928","authenticated-orcid":false,"given":"Scott","family":"Sakaguchi","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Variety Club Research Centre, University of Minnesota, 401 East River Parkway, 2nd Floor, Minneapolis, MN 55455, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3880-2722","authenticated-orcid":false,"given":"Ganesh","family":"Kasinadhuni","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venkatakrishna N","family":"Tholakanahalli","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Variety Club Research Centre, University of Minnesota, 401 East River Parkway, 2nd Floor, Minneapolis, MN 55455, USA"},{"name":"Cardiovascular Division, Minneapolis VA Healthcare Systems, 1, Veterans Drive, Minneapolis, MN 55417, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,9,27]]},"reference":[{"year":"2009","author":"McGee","key":"2021013107452518000_ytz142-B1"},{"key":"2021013107452518000_ytz142-B2","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1093\/europace\/eus054","article-title":"Pneumothorax in cardiac pacing: a population-based cohort study of 28,860 Danish patients","volume":"14","author":"Kirkfeldt","year":"2012","journal-title":"Europace"},{"key":"2021013107452518000_ytz142-B3","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1016\/0735-1097(89)90236-2","article-title":"Pacemaker-implantation complication rates: an analysis of some contributing factors","volume":"13","author":"Parsonnet","year":"1989","journal-title":"J Am Coll 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implantation","volume":"14","author":"Duan","year":"2012","journal-title":"Europace"},{"key":"2021013107452518000_ytz142-B7","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1136\/hrt.2010.203919","article-title":"Central venous spasm during pacemaker insertion","volume":"96","author":"Cooper","year":"2010","journal-title":"Heart"},{"key":"2021013107452518000_ytz142-B8","doi-asserted-by":"crossref","first-page":"543","DOI":"10.5603\/FM.a2016.0027","article-title":"Axillary vein spasm during cardiac implantable electronic device implantation","volume":"75","author":"Steckiewicz","year":"2016","journal-title":"Folia Morphol"},{"key":"2021013107452518000_ytz142-B9","doi-asserted-by":"crossref","first-page":"464","DOI":"10.5603\/FM.a2018.0001","article-title":"Vasoconstrictive responses of the cephalic vein during first-time cardiac implantable electronic device placement","volume":"77","author":"Steckiewicz","year":"2018","journal-title":"Folia Morphol (Warsz)"},{"key":"2021013107452518000_ytz142-B10","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1093\/europace\/eus233","article-title":"Efficacy and safety of nitroglycerin for preventing venous spasm during contrast-guided axillary vein puncture for pacemaker or defibrillator leads implantation","volume":"15","author":"Duan","year":"2013","journal-title":"Europace"},{"key":"2021013107452518000_ytz142-B11","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1111\/j.1540-8159.1993.tb01018.x","article-title":"A new approach to percutaneous subclavian venipuncture to avoid lead fracture or central venous catheter occlusion","volume":"16","author":"Magney","year":"1993","journal-title":"Pacing Clin Electrophysiol"}],"container-title":["European Heart Journal - Case 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