{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T07:58:52Z","timestamp":1758095932858,"version":"3.44.0"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","award":["ERC PREDICT\u2010HF 864055"],"award-info":[{"award-number":["ERC PREDICT\u2010HF 864055"]}],"id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Central venous obstruction (CVO) increases the complexity of pacing interventions, whether it be with device\u2010associated symptomatic superior vena cava syndrome (SVCS), or by impeding new implants. Endovascular treatment involves the joint expertise of both cardiac pacing and vascular specialists. We report the outcomes of such procedures at our institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A single\u2010center retrospective observational study, examining outcomes of joint pacing\u2010vascular procedures for CVO. Cases were screened from an existing institutional database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 19 total cases. Two were new device implants where the novel \u201cinside\u2010out\u201d procedure was utilized to establish access in SVCS, both with no complications. The remainder (<jats:italic>n<\/jats:italic>\u00a0=\u00a017) were transvenous lead extractions plus attempted recanalization of CVO using venoplasty with or without stenting. Transvenous devices were re\u2010implanted in eight patients. Complete procedure success rate was 84%. There were two cases of pericardial effusion requiring pericardiocentesis, resulting in procedure abandonment. There was no in\u2010hospital mortality and no cases of emergency sternotomy. Over mean follow\u2010up of 28 months, 2\/6 patients receiving venoplasty (33%) and 2\/8 patients receiving stenting (25%) required re\u2010intervention for symptomatic restenosis. Of the patients who were not re\u2010implanted with a transvenous device following initially successful endovascular intervention (6\/14), none had recurrence over the follow\u2010up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pacing interventions in SVCS carry a significant risk profile, requiring management by experienced operators in high\u2010volume centers to maximize safety. Endovascular interventions have a significant recurrence rate, with up\u2010front stenting potentially being superior. Our data suggests that those without re\u2010implantation of transvenous leads may have better long term outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.70019","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T17:34:08Z","timestamp":1753983248000},"page":"959-966","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Joint Pacing and Vascular Intervention for the Management of Cardiac Device Associated Central Venous Obstruction"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7893-0708","authenticated-orcid":false,"given":"Nadeev","family":"Wijesuriya","sequence":"first","affiliation":[{"name":"King's College London  London UK"},{"name":"Guy's and St Thomas's NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Sinabulya","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas's NHS Foundation Trust  London UK"},{"name":"Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Johann\u2010Meyer","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas's NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisha","family":"Kellman","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas's NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicity","family":"de Vere","sequence":"additional","affiliation":[{"name":"King's College London  London UK"},{"name":"Guy's and St Thomas's NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Howell","sequence":"additional","affiliation":[{"name":"King's College London  London UK"},{"name":"Guy's and St Thomas's NHS Foundation Trust  London 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