Progression of venous pathology after pacemaker and cardioverter-defibrillator implantation: A prospective serial venographic study.
OBJECTIVE
Prospective data on development of venous obstruction after electrode implantation are limited. We performed a prospective study on 150 patients undergoing first pacemaker implantation.


METHODS
Venographies at base-line and 6 months postimplantation in all patients, 50 patients included into a long-term follow-up of a mean of 2.4 years after implantation.


RESULTS
At 6 months 14% had obstructions, but only 1 patient (0.7%) developed acute symptomatic upper extremity venous thrombosis. Pulmonary embolism (PE) was encountered in 5 (3.3%). After 6 months only 2 patients experienced pain in ipsilateral arm, but none had edema of arm, neck or head, or clinical PE. The 5 patients with total venous occlusion (TVO) at 6 months had no localized symptoms. Late venographic abnormalities developed in 5 (10%) patients: 4 TVOs and 1 stenosis. Two of the new lesions developed among 25 patients with normal 6-month venograms. Overall, TVO was detected in 9 of 150 patients. No factors emerged as independent predictors of total occlusion in multiple regression analysis.


CONCLUSIONS
TVO is not uncommon after pacemaker implantation, and mostly occurs without any localizing symptoms. Most venous lesions seem to develop during the first months postimplantation, but late and unpredictable TVO may also occur.
Korkeila
Petri
P
Turku University Hospital, Kiinamyllynkatu 4-8, Turku, Finland. petri.korkeila@tyks.fi
Ylitalo
Antti
A
Koistinen
Juhani
J
Airaksinen
K E Juhani
KE
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D003251:Constriction, Pathologic / Q000209:etiology; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D010690:Phlebography; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D012307:Risk Factors; D013997:Time Factors; D014680:Veins / Q000473:pathology*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*