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

Abstract

Abstract Background The use of cardiac implantable electronic device have grown substantially over the past two decades, lead related vascular issues are commonly encountered in clinical practice. Superior vena cava (SVC) syndrome due to pacemaker leads is an uncommon complication. Anticoagulation currently remains the mainstay of therapy to restore some degree of patency and relieve swelling. However, there is very limited clinical trials on direct oral anticoagulants (DOACs) . Case presentation: We report a case of a 80-year-old man who developed SVC syndrome after transvenous pacemaker implantation with symptoms of obstruction were significantly relieved after four months of DOACs. His symptoms had complete resolved nine months later. Conclusions DOACs are effective in the treatment of SVC syndrome after pacemaker implantation, representing an important new approach. It is a very good choice for patients who do not want to undergo interventional therapy.