Central venous spasm during pacemaker insertion.

摘要

An 83-year-old female presented with syncope. She was found to be in complete heart block with an escape rhythm of 40 bpm. Following admission she remained haemodynamically stable with no prolonged pauses; she was therefore listed for pacemaker implantation the next morning.Initial attempts at venous access were right-sided due to recent left shoulder surgery. A venogram revealed good calibre venous anatomy. Several attempts were made at venous puncture with good flashback, but attempts to pass standard and hydrophilic guidewires were unsuccessful. The patient became uncomfortable so the procedure was abandoned