Clinical Research
Clinical risk factors of venous occlusion induced by implantable device leads
Chao Li, Keping Chen, Yan Dai, Yuqiu Li, Wei Hua, Shu Zhang
Published 2019-12-28
Cite as Chin J Cardiac Arrhyth, 2019, 23(6): 524-529. DOI: 10.3760/cma.j.issn.1007-6638.2019.06.009
Abstract
ObjectiveVenous occlusion was a common complication of transvenous lead implantation, but the risk factors for venous occlusion had not been well defined to date. This study was designed to evaluate the incidence of this complication and explore the risk factors of this complication in a large consecutive cohort.
MethodsFrom January 2017 to April 2018, a total of 106 consecutive patients who had undergone generator replacement, lead revision, or device upgrade therapy at the Arrhythmia Center of Fuwai Hospital were enrolled. A contrast venography examination of the ipsilateral access vein was performed to confirm the presence or absence of venous occlusion. According to the results of venography, patients with normal and mild to moderate stenosis (<75%) were classified as venous non-occlusion group, and with severe stenosis (≥75%) or total occlusion (100%) were divided into venous occlusion group. Variables clinical data, such as age, sex, type of pacemaker, manufacturer of electrode lead, number of leads, implant duration, combined basic diseases, clinical drug use and related laboratory data, were analyzed between two groups. We utilized Logistic regression model to search for the risk factors of venous occlusion.
ResultsOverall, 26 of 106 patients had severe stenosis or occlusion of the subclavian or innominate vein (24.5%) , with 11.3% of patients having severe stenosis and 13.2% of patients having total obstruction. Implantable cardioverter defibrillator (ICD) leads significantly increased the incidence of severe stenosis and occlusion of related veins (23% vs. 4%, P=0.008) , moreover baseline creatinine levels in patients with venous occlusion were significantly higher than those in venous non-obstructed group [ (86.78±25.40) mmol/L vs. (72.08±15.11) mmol/L, P=0.009] . In the Logistic regression analysis, renal insufficiency was highly correlated with venous complications (odd ratio [OR] 1.047; 95%CI 1.012-1.083, P=0.009) .
ConclusionThe clinical incidence of venous occlusion after cardiac device implantation is relatively high. Renal insufficiency was associated with above complications.
Key words:
Cardiac pacing, artificial; Lead wire; Venous occlusion; Risk factors
Contributor Information
Chao Li
Center of Arrhythmia, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
Keping Chen
Yan Dai
Yuqiu Li
Wei Hua
Shu Zhang
