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Venous obstruction after permanent pacing.

A K Kar1, S Ghosh, A Majumdar

  • 1Department of Cardiology, Seth Suklal Karnani Memorial Hospital, Calcutta.

Indian Heart Journal
|November 21, 2000
PubMed
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Permanent pacemaker implantation can cause venous obstruction, identified via contrast venography. Early detection and treatment are crucial for managing these serious complications and planning lead revisions.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Medical Devices

Background:

  • Permanent pacemaker implantation is a common procedure.
  • Venous obstruction is a potential complication following pacemaker lead insertion.
  • Identifying and managing venous obstruction is critical for patient outcomes.

Purpose of the Study:

  • To investigate the incidence and characteristics of venous obstruction in patients with permanent pacemakers.
  • To evaluate the utility of contrast venography in diagnosing venous obstruction.
  • To assess treatment outcomes for venous obstruction post-pacemaker implantation.

Main Methods:

  • A 10-year prospective study of 6,256 patients with permanent pacemakers.
  • Contrast venography was performed on patients presenting with symptoms of venous obstruction.

Related Experiment Videos

  • Patients received anticoagulation therapy (heparin and/or oral anticoagulants).
  • Main Results:

    • 22 out of 6,256 patients (0.35%) showed subclavian and/or superior vena cava thrombotic/fibrotic obstruction.
    • Obstructions were characterized by non-progressive dilated superficial veins on the upper chest wall.
    • Heparin followed by oral anticoagulants provided relief in 3 of 7 patients.
    • Two patients required epicardial pacing due to superior vena cava obstruction.

    Conclusions:

    • Contrast venography is valuable for assessing venous obstruction before pacemaker lead revision.
    • Timely diagnosis and appropriate anticoagulation can manage venous obstruction.
    • Alternative lead insertion routes may be necessary in cases of severe obstruction.