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Upper extremity deep venous thrombosis and stenosis after implantation of pacemakers and defibrillators; A

Morteza Safi1, Mohammad Ali Akbarzadeh1, Azadeh Azinfar1

  • 1.

Romanian Journal of Internal Medicine = Revue Roumaine De Medecine Interne
|April 23, 2017
PubMed

Insights

Venous obstruction after cardiac device implantation is common, particularly with multiple leads. Pacemaker and implantable cardioverter-defibrillator leads pose similar risks for this complication.

Area of Science:

  • Cardiology
  • Medical Devices
  • Vascular Medicine

Background:

  • Venous obstruction is a frequent complication after cardiac pacemaker and defibrillator implantation.
  • The precise incidence and risk factors for venous obstruction remain largely unknown.

Purpose of the Study:

  • To determine the incidence of venous obstruction following cardiac device implantation.
  • To analyze the contribution of individual risk factors to venous obstruction.

Main Methods:

  • 57 patients undergoing first-time transvenous pacemaker, implantable cardioverter-defibrillator (ICD), or cardiac resynchronization therapy device implantation were enrolled.
  • Peripheral arm venography was performed post-implantation and again at 3-6 months follow-up.

Main Results:

  • 21% of 42 completing patients showed significant venous obstruction (>50%) at follow-up.
  • Increased lead number (2.56 vs 1.58) was significantly associated with obstruction (P=0.001).
  • Cardiac resynchronization therapy patients had higher obstruction rates (P=0.01); multivariate analysis identified total lead number as a positive predictor (OR: 19.2, P=0.015).

Conclusions:

  • Venous obstruction is a relatively frequent complication after pacemaker or ICD implantation.
  • Pacemaker and ICD leads present similar risks for venous obstruction.
  • Patients with multiple leads have an increased risk of venous obstruction.
Abstract

Keywords:
ComplicationsImplantable cardioverter-defibrillatorPacemakerRisk factorsVenous obstruction

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