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Implantable defibrillation and thromboembolic events
G Benedini1, A Marchini, A Curnis
1University of Brescia, Italy.
Insights
Thromboembolic events (TEEs) can occur in patients with implantable cardioverter-defibrillators (ICDs). This study found TEEs in 6.5% of patients, highlighting potential risks during follow-up.
Area of Science:
- Cardiology
- Medical Devices
- Thrombosis
Background:
- Thromboembolic events (TEEs) are known complications associated with implantable cardioverter-defibrillators (ICDs).
- Understanding the incidence and etiology of TEEs in ICD patients is crucial for patient management.
Observation:
- Four cases of TEEs (two peripheral, two cerebral) were observed in a series of ICD patients.
- These events occurred during a mean follow-up of 19.4 months.
- Affected patients had chronic postinfarction left ventricular (LV) aneurysm or idiopathic dilated cardiomyopathy, with no prior embolism history or detectable LV clots.
Findings:
- The incidence of TEEs in this cohort was 6.5%.
- No atrial fibrillation episodes were documented before or after ICD implantation.
- The study identified potential causes for embolization in this patient group.
Implications:
- The findings suggest a need for careful consideration of thromboembolic risk in ICD recipients, even without traditional risk factors.
- Further research into the suitability and efficacy of anticoagulant therapy in ICD patients is warranted.
- This study contributes to the understanding of TEEs in the context of ICD implantation and management.
Abstract:
In ICD patients thromboembolic events (TEEs) are described as possible complications at implant or during the follow-up. We report four cases of TEEs (two peripheral and two cerebral; 6.5% of patients) that occurred in our series during a mean follow-up of 19.4 months. The patients had chronic postinfarction LV aneurysm (3) and idiopathic dilated cardiomyopathy (1). None had previous embolisms nor evidence of left atrial or LV clots at standard preoperative transthoracic echocardiography. No paroxysms of atrial fibrillation were documented prior or after ICD implant. We discuss the possible causes of embolization and the suitability of anticoagulant therapy in ICD patients.