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Transvenous endocardial pacing has been widely accepted as an effective means to treat patients with bradycardia, though there are some complications unique to this approach. For example, occlusion of the major vessels can be induced by the presence of a single pacing electrode, though it is an extremely rare occurrence. In this paper, we describe 2 cases of venous obstruction complications caused by dual-chamber pacemaker implantation. Venographic studies were useful to confirm the diagnosis, and immediate anticoagulant therapy resulted in a good course. It is speculated that this phenomenon will increase as physiological, dual-chamber pacing becomes more widely performed. Physicians must pay careful attention to the complication of venous obstruction when managing patients with implanted transvenous dual-chamber pacemakers.

Total venous obstruction. A possible complication of transvenous dual-chambar pacing.