[Complications in the venous system in patients with transvenous implanted pacemakers]

There is a little account in the literature regarding early and late thrombotic complications in connection with permanent pacer application (PPA), although, clinically this is of relevance. Therefore, upper thoracic phlebography (UTP) was carried out 44 +/- 10 months after PPA in 100 consecutive pts with a mean age of 62 years. Sixty-one UPTs were normal, 15 UTPs showed occlusions of the axillary and/or subclavian vein and 24 presented with minor thrombotic changes. Reliable clinical diagnoses had been made in 10 pts only prior to UTP. In addition, 12 pts had UTPs 19 +/- 12 months after malfunctioning electrodes had been severed and each proximal stump left within the venous cavity on occasion of the repeated PPA. Clinical complications in these pts consisted of total occlusion of the superior caval vein in 2 and multiple pulmonic embolism (clinically and scintigraphically) in 3 pts. With the mobile part of the retained electrode above the left brachiocephalic vein inflow in 8 pts, occlusion had taken place in this very region. In addition, the free floating stump of the electrode was found in the pulmonary artery, in the right atrium and the right ventricle, in one pt each.