title: Prevalence of asymptomatic upper extremity venous obstruction in 302 patients undergoing first implantation of cardioverter defibrillator.
abstract: BACKGROUND
  Little is known about the prevalence of upper extremity vein obstruction or anomalies in patients before first implantation of implantable cardioverter defibrillator (ICD). It remains unclear in which patients contrast venography is warranted before implantation procedure.
  
  
  METHODS
  Results of clinical data and contrast venography of 302 consecutive patients scheduled for first ICD implantation were analyzed.
  
  
  RESULTS
  Prevalence of upper vein obstruction was 6.6% (20/302 patients) in a typical patient population undergoing first ICD implantation. Age, left ventricular ejection fraction, underlying heart disease, prior open-heart surgery, or cardiopulmonary resuscitation were not predictors of obstruction. Patients with previous cardiac pacemaker implantation had a higher rate of obstruction, though this was not statistically significant (20% vs 15.7%, P = 0.54). Persistent left vena cava was found in 0.7%.
  
  
  CONCLUSIONS
  There is no clinical parameter sufficient enough to predict upper extremity venous obstruction. Contrast venography may be considered in patients with previous pacemaker placement but should not be a routine diagnostic tool in unselected patients prior to first ICD-implantation procedure.
authors.affiliation: Medizinische Klinik und Poliklinik II, University of Bonn, Bonn, Germany. markus.linhart@ukb.uni-bonn.de
authors.forename: Markus
authors.initials: M
authors.lastname: Linhart
authors.forename: Jörg O
authors.initials: JO
authors.lastname: Schwab
authors.forename: Barbara
authors.initials: B
authors.lastname: Bellmann
authors.forename: Jan W
authors.initials: JW
authors.lastname: Schrickel
authors.forename: Jens
authors.initials: J
authors.lastname: Kreuz
authors.forename: Osman
authors.initials: O
authors.lastname: Balta
authors.forename: Claas P
authors.initials: CP
authors.lastname: Naehle
authors.forename: Katharina
authors.initials: K
authors.lastname: Strach
authors.forename: Christian
authors.initials: C
authors.lastname: Schneider
authors.forename: Bahman
authors.initials: B
authors.lastname: Esmailzadeh
authors.forename: Rolf
authors.initials: R
authors.lastname: Fimmers
authors.forename: Georg
authors.initials: G
authors.lastname: Nickenig
authors.forename: Lars M
authors.initials: LM
authors.lastname: Lickfett
mesh_terms: D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D034941:Upper Extremity / Q000098:blood supply*; D014689:Venous Insufficiency / Q000453:epidemiology*