title: Venous Stenosis and Occlusion in the Presence of Endocardial Leads.
abstract: BACKGROUND
  Venous stenosis and occlusion in the presence of endocardial leads constitute one of the complications of permanent cardiac pacing either by pacemaker, implantable cardioverter-defibrillator or cardiac resynchronization therapy.
  
  
  OBJECTIVE
  The aim of this study was to assess the incidence of stenosis and occlusions and determine the risk factors in patients with endocardial leads in a prospective single-center study.
  
  
  METHODS
  Two hundred eighty consecutive patients aged 25-95 years (male 68.8%) were included. A contrast venography examination of the ipsilateral access vein was performed. The whole study population was divided into 2 groups, based on the presence (group I) or absence (group II) of endocardial leads.
  
  
  RESULTS
  Venous stenosis/occlusion was identified in 51 patients (37.5%) in group I and in 3 patients (3.6%) in group II; p < 0.0001. The lead presence most highly correlated with venous complications (OR = 4.172; p < 0.001). In patients with endocardial leads divided into I A and I B according to venous patency diabetes mellitus was proved in multivariate analysis to be the only protective factor against the development of venous stenosis/occlusion (OR = 0.473; p = 0.010).
  
  
  CONCLUSIONS
  The presence of endocardial leads is a predisposing factor for venous stenosis/occlusion and increases the risk 4-fold. The venous lesions in the presence of endocardial leads are less frequent among patients with diabetes mellitus.
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Kraków, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Boczar
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Kraków, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Ząbek
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Kraków, Poland; Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Haberka
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Kraków, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Hardzina
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Kraków, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Dębski
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Kraków, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Rydlewska
authors.affiliation: Outpatient Clinic, Scanmed Multimedis, Kraków, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Nowosielska-Ząbek
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Kraków, Poland; Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Lelakowski
authors.affiliation: Department of Electrocardiology, John Paul II Hospital, Kraków, Poland; Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Małecka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058409:Cardiac Resynchronization Therapy Devices / Q000009:adverse effects; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D016009:Chi-Square Distribution; D002932:Cineangiography; D003251:Constriction, Pathologic; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D010690:Phlebography / Q000379:methods; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies; D011474:Prosthesis Design; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D014654:Vascular Patency; D014680:Veins / Q000503:physiopathology