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Related Experiment Videos

Venous obstruction after pacemaker implantation.

Petri Korkeila1, Kai Nyman, Antti Ylitalo

  • 1Turku University Hospital, Turku, Finland. Petri.korkeila@tyks.fi

Pacing and Clinical Electrophysiology : PACE
|March 7, 2007
PubMed
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Pacemaker and defibrillator leads can cause central vein obstruction, affecting 14% of patients within 6 months. Atrial fibrillation and biventricular device implantation predict this venous obstruction.

Area of Science:

  • Cardiovascular Medicine
  • Medical Device Technology
  • Interventional Cardiology

Background:

  • Central venous leads for pacemakers and defibrillators are associated with venous obstruction.
  • While often asymptomatic, venous obstruction can complicate lead extraction.
  • Prospective quantification of venous caliber changes post-implantation is needed.

Purpose of the Study:

  • To prospectively quantify changes in central vein caliber after pacemaker (PM) or cardioverter-defibrillator (ICD) implantation.
  • To determine the incidence of new venous obstruction post-device implantation.
  • To identify predictors of venous obstruction development.

Main Methods:

  • 150 patients undergoing PM/ICD implantation were enrolled and followed for 6 months.

Related Experiment Videos

  • Intravenous contrast venography (ICV) was performed at baseline and 6-month follow-up.
  • New stenosis was defined as a ≥50% diameter reduction compared to baseline.

    • Main Results:

    • 14% of patients developed new venous obstructive lesions within 6 months.
    • Stenosis occurred in 10% (mean D(min) 4.6 mm, 38% of baseline) and occlusion in 3.6%.
    • Atrial fibrillation and biventricular PM implantation were independent predictors of venous obstruction.

    Conclusions:

    • Venous anomalies complicating PM implantation are common.
    • The incidence of new venous obstruction after PM/ICD implantation is 14%.
    • Atrial fibrillation and biventricular device type independently predict venous obstruction.