Venous Thromboembolism in Patients with Cardiac Implantable Electronic Devices

  • #VS 01-O-7
  • Vascular Surgery. SESSION-1
  • Oral

Venous Thromboembolism in Patients with Cardiac Implantable Electronic Devices

Igor A. Suchkov 1, Roman E. Kalinin 1, Nina D. Mzhavanadze 1, Vladislav O. Povarov 1, Aleksey A. Kamaev 1, Igor I. Shitov 2

Ryazan State Medical University, Ryazan, Russia; Ryazan Regional Clinical Cardiologic Dispensary, Ryazan, Russia;

Date, time and location: 2018.05.25 13:30, Congress Hall, 2F–B


Objective: assessment of prevalence of venous thromboembolism (VTE) in patients with cardiac implantable electronic devices (CIED).

Material and methods: the study included 45 patients (22 men and 23 women) aged from 51 to 84 years. Median age was 72.2 ± 8.1 years. All patients had indications for pacemaker implantation. 19 (42.2 %) patients presented with atrioventricular block, 18 (40 %) subjects – with atrial fibrillation with significantly impaired atrioventricular conduction, 8 (17.8 %) patients – with sick sinus node syndrome. Physical examination and duplex ultrasound (DUS) of the upper and lower limb veins were performed in all patients before and at 1 month after pacemaker implantation.

Results: prior to CIED implantation vein patency was confirmed by physical examination and DUS in all subjects. 25 single-chamber and 20 dual-chamber pacemakers were successfully implanted. Lead implantation was performed via cephalic vein in 38 (84.4 %) patients, via subclavian vein - in 6 (13.3 %) patients, and via muscle branches of subclavian vein system in 2 (3.3 %) patients due to technical issues. At 1 month after implantation of CIED VTE prevalence was 11.1 %. In 2 (4.4 %) cases DUS identified occlusion of subclavian vein, in 1 (2.2 %) case – occlusion of cephalic vein, in 1 (2.2 %) case – lower extremity deep veins thrombosis at the level of inferior vena cava, and in 1 (2.2 %) case – thrombosis of additional great saphenous vein, the latter - asymptomatic. Age, gender, diabetes mellitus, hypertension, ischemic heart disease, number of leads, device type or CIED placement technique did not have any statistically significant impact on the risk for thrombosis.

Conclusion: more than 1 in 10 patients who undergo CIED placement may suffer from venous thromboembolism. Future studies are needed to identify possible risk factors for thrombosis in CIED patients.

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