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

¹ Ryazan State Medical University, Ryazan, Russia; ² Ryazan Regional Clinical Cardiologic Dispensary, Ryazan, Russia;

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

Abstract

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.