Superior vena cava obstruction caused by repeated radiofrequency sinus node modification procedures

Abstract

A 26-year-old woman was referred for implantation of a pacemaker for symptomatic bradycardia. She had undergone 3 prior radiofrequency (RF) sinus node modification procedures for symptomatic sinus tachycardia 28, 27, and 16 months before referral, respectively. As a result, her underlying rhythm was an accelerated junctional rhythm. She was dyspneic with minimal exertion and reported fatigue, palpitations, atypical chest pain, and headaches. Her heart rate and symptoms were refractory to medical trials of theophylline and hyoscymine.