title: Thromboembolic events during the perioperative period in patients undergoing permanent pacemaker implantation.
abstract: BACKGROUND
  Thromboembolism (TE) is one of the most serious complications after pacemaker implantation. It has been demonstrated that several patient characteristics and different pacing modes are related to an increased risk of TE events during long-term follow-up.
  
  
  OBJECTIVE
  We propose that TE events occurring during the perioperative period of pacemaker implantation may be associated with certain clinical characteristics.
  
  
  METHODS
  The potential risk factors of TE events were analyzed in 406 consecutive patients who underwent pacemaker implantation.
  
  
  RESULTS
  We identified TE events in 11 patients (2.7%) within 7 days after pacemaker implantation. Four of the 11 (36.4%) patients died of complications of TE. Univariate analysis revealed that an age of >75 years (4.56 odds ratio [OR], P = 0.031), hypertension (3.59 OR, P = 0.028), diabetes (8.89 OR, P < 0.001), coronary heart disease (4.8 OR, P = 0.005), atrial fibrillation (AF) (5.68 OR, P = 0.006), persistent AF (10.36 OR, P < 0.001), and a history of stroke or transient ischemic attack (5.62 OR, P = 0.002) were associated with an increased risk of TE events. Multivariate logistic analysis showed that persistent AF (9.8 OR, P < 0.001) was independently associated with TE. The incidence of perioperative TE was not significantly different between patients with single- and dual-chamber pacemakers.
  
  
  CONCLUSIONS
  We found TE events during the perioperative period in patients undergoing pacemaker implantation were not uncommon. Because persistent AF during the perioperative period was the only independent risk factor for perioperative TE, appropriate anticoagulation therapy may be necessary in those patients. © 2012 Wiley Periodicals, Inc. J. Liu, MD, is co-first author. The authors have no funding, financial relationships, or conflicts of interest to disclose.
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, College of Medicine, Shanghai Jiaotong University, Shanghai, China. shaowen.liu@hotmail.com
authors.forename: Songwen
authors.initials: S
authors.lastname: Chen
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.forename: Wenzhi
authors.initials: W
authors.lastname: Pan
authors.forename: Shaowen
authors.initials: S
authors.lastname: Liu
authors.forename: Yangang
authors.initials: Y
authors.lastname: Su
authors.forename: Jin
authors.initials: J
authors.lastname: Bai
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Junbo
authors.initials: J
authors.lastname: Ge
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010138:Pacemaker, Artificial; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology*