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Venous Stenosis and Occlusion in the Presence of Endocardial Leads

Krzysztof Boczar1, Andrzej Ząbek1, Kazimierz Haberka2

  • 1Department of Electrocardiology, John Paul II Hospital, Kraków, Poland.

Advances in Clinical and Experimental Medicine : Official Organ Wroclaw Medical University
|March 4, 2016
PubMed

Insights

Endocardial leads for cardiac pacing significantly increase the risk of venous stenosis and occlusion. Diabetes mellitus appears to be a protective factor against these lead-related venous complications.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Endocardial leads, used in pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy, can lead to venous stenosis and occlusion.
  • These venous complications are recognized risks associated with permanent cardiac pacing devices.

Purpose of the Study:

  • To determine the incidence of venous stenosis and occlusion in patients with endocardial leads.
  • To identify risk factors associated with these venous complications in patients undergoing cardiac pacing.

Main Methods:

  • A prospective, single-center study included 280 patients (aged 25-95 years).
  • Patients were categorized into two groups: those with endocardial leads (Group I) and those without (Group II).
  • Contrast venography of the ipsilateral access vein was performed to assess venous patency.

Main Results:

  • Venous stenosis/occlusion was significantly more prevalent in patients with endocardial leads (37.5%) compared to those without (3.6%) (p < 0.0001).
  • The presence of endocardial leads was strongly correlated with venous complications, showing a 4-fold increased risk (OR = 4.172; p < 0.001).
  • In patients with leads, diabetes mellitus was identified as a significant protective factor against venous stenosis/occlusion (OR = 0.473; p = 0.010).

Conclusions:

  • Endocardial leads are a significant predisposing factor for venous stenosis and occlusion, increasing the risk substantially.
  • The incidence of venous lesions associated with endocardial leads is notably lower in patients with diabetes mellitus.
Abstract

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