Relationship between changes in selected thrombotic and inflammatory factors, echocardiographic parameters and the incidence of venous thrombosis after pacemaker implantation based on our own observations
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Published on: October 28, 2020
Jacek Lelakowski1, Teresa Barbara Domagała, Anna Rydlewska
1Department of Electrocardiology, Institute of Cardiology, The John Paul II Hospital, School of Medicine, Jagiellonian University, Cracow, Poland.
Insights
Pacemaker implantation can lead to venous thrombosis (VTh). Elevated levels of inflammatory and thrombotic factors, particularly D-dimers, fibrinogen, and tissue factor, indicate a higher risk for VTh development post-procedure.
Area of Science:
- Cardiology
- Vascular Medicine
- Biochemistry
Background:
- Venous thrombosis (VTh) is a rare but serious complication following pacemaker implantation (PM).
- Understanding the dynamic changes in thrombotic and inflammatory markers is crucial for risk assessment.
Purpose of the Study:
- To investigate the changes in key thrombotic and inflammatory factors after PM.
- To identify factors associated with the development of VTh in PM patients.
Main Methods:
- Prospective study of 81 patients undergoing PM, divided into VTh (n=10) and no VTh (n=71) groups.
- Biomarker analysis (D-dimers, fibrinogen, TF, Factor VII, PAI-1, IL-6, hsCRP) at baseline, 7 days, 6 months, and 12 months post-PM.
- Transthoracic echocardiogram and venous ultrasound performed at baseline, 6, and 12 months.
Main Results:
- Patients who developed VTh had significantly higher baseline levels of IL-6, hsCRP, D-dimers, fibrinogen, TF, Factor VII, and PAI-1.
- These markers increased in all patients within 7 days post-PM.
- In the VTh group, marker levels continued to rise, while they decreased in the no-VTh group.
Conclusions:
- Elevated inflammatory and thrombotic factors are present before and after PM in patients who develop VTh.
- D-dimers, fibrinogen, and tissue factor are identified as high-risk factors for VTh occurrence after PM.
Introduction:
Thrombosis (VTh) is a rare dangerous complication of pacemaker implantation (PM). The aim of the study was to determine the dynamics of change in selected thrombotic and inflammatory factors after PM.
Material And Methods:
The study involved 81 patients (30 female, mean age: 71.1 years) with PM, divided into two groups. Group A (71 patients) consisted of patients without VTh, whereas group B (10 patients) comprised the patients with VTh. A transthoracic echocardiogram (TTE) and a venous ultrasound (VU) examination were performed. The levels of D-dimers, fibrinogen, tissue factor (TF), factor VII, plasminogen activator inhibitor-1 (PAI-1), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) were determined in the venous blood. After PM, the TTE and VU examinations were repeated at 6 and 12 months, and blood analyses were performed within 7 days after PM, and subsequently at 6 and 12 months.
Results:
In 10 patients of group B, symptomatic VTh occurred at a mean time of 13.06 months after PM. Initially, the levels of IL-6, hsCRP, D-dimers, fibrinogen, TF, VII factor and PAI-1 were considerably higher in group B than in group A. In all patients the levels of these factors kept on increasing for up to 7 days after the procedure. In group A they subsequently decreased, whereas in group B they continued to rise.
Conclusions:
Increased levels of inflammatory and thrombotic factors were observed in patients with VTh before and after PM. The factors of highest risk of VTh occurrence were D-dimers, fibrinogen and TF.
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