![]() Mazzetti H, Dussaut A, Tentori C et al (1993) Superior vena cava occlusion and/or syndrome related to pacemaker leads. Mayo Clin Proc 67:258–265Īntonelli D, Turgeman Y, Kaveh Z et al (1989) Short-term thrombosis after transvenous permanent pacemaker insertion. ![]() Spittell PC, Hayes DL (1992) Venous complications after insertion of a transvenous pacemaker. This process is experimental and the keywords may be updated as the learning algorithm improves. These keywords were added by machine and not by the authors. ![]() Even if their data do not conclusively demonstrate a precise causal relationship between platelet activation and increase of TEEs in patients with pacemakers or ICDs, they strongly suggest that antiplatelet drugs could represent a pathogenic treatment in these patients. have shown an increase of TEEs (fatal and nonfatal stroke, fatal and nonfatal myocardial infarction, inferior limb thromboembolism) in patients treated with antiplatelet therapy compared to those not so treated ( p < 0.05) they have shown a significant increase of β-Tromboglobulin (β-Tg) in paced patients with respect to controls. In some reports on the evaluation of antiplatelet therapy and platelet aggregability in patients with pacing, Fazio et al. In addition, the pacing lead may produce a foreign-body type of reaction and subsequent inflammation and fibrosis along the course of the lead. The presence of multiple transvenous pacemaker leads, especially if one is severed, also increases the risk of thrombosis. The long-term residence of a permanent lead in the venous system may also act a continuing nidus for formation of a thrombus. Venous thrombosis that occurs more than 1 year after implantation of a permanent transvenous pacemaker is usually associated with underlying venous stenosis, which may result from fibrosis of preexistent venous thrombi. Interventricular and intraventricular asynchronism of contraction. Old age in patients with pacemaker or ICD ![]() Presence of the lead in the right ventricle Hypercoagulability induced by the surgical procedureĪtrioventricular asynchronism that causes numerous atrial contractions against closed atroventricular valves (this mechanism is even more significant in patients with 1:1 ventricular retrograde conduction) Lead-induced endothelial trauma, which causes local release of coagulation factors Possible causes of early thrombosis include the following:Įxtrusion of thrombus from the ligated vein (especially with the cephalic vein approach) The pathogenesis of venous thrombosis after implantation of a permanent transvenous pacemaker or ICD has not been clearly determined. An understanding of the thromboembolic complications of transvenous cardiac pacing is important because prompt diagnosis and therapy may diminish the potential for morbidity and mortality. Venous stenosis and thrombosis after permanent cardiac pacing are probably more common than previously thought because most patients remain asymptomatic and the condition remains undetected. However, venous obstruction can also occurr soon after implantation. TEEs have traditionally been reported as a late problem (more than 1 month after implantation of a pacemaker or ICD), and embolic complications have been reported as occurring at any time following implantation. TEEs associated with the implantation or chronic presence of permanent pacing leads have been described in many case reports but are actually considered a relatively uncommon complication of cardiac pacing. Patients with atherosclerosis, valvular, ischemic, and dilatative cardiomyopathies, or atrial fibrillation, and those with a cardiac valvular prothesis, by-pass, pacemaker, or ICD, may be subject to thrombotic or thromboembolic events (TEEs).
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