LONG-TERM THROMBOSIS AFTER TRANSVENOUS PERMANENT PACEMAKER IMPLANTATION

To assess the efficacy of prophylactic administration of anticoagulant and antiaggregant drugs to prevent venous thrombosis after long-term transvenous permanent pacemaker implantation, venograms were performed in 100 consecutive patients at the elective replacement of the pacema ker. Mean follow-up period after initial transvenous permanent pacemak er implantation was 6.0 years. The venograms demonstrated normal in 77 patients. The remaining 23 venograms showed venous stenosis in 11 pat ients and total obstruction in 12 patients. Twenty-one of these 23 pat ients had venous collateral circulation. No difference was found in th e incidence of venous abnormalities according to the route of entry, t he lead insulation, the total number of the implanted leads, and antic oagulant and antiaggregant drugs. All these patients have remained asy mptomatic. In conclusion, the incidence of venous thrombosis after lon g-term transvenous pacing is 23% and the causes of venous thrombosis m ay be endothelial trauma and underlying venous stenosis. As this artic le describes a retrospective limited study, we cannot find the efficac y of prophylactic administration of anticoagulant and antiaggregant dr ugs to prevent venous thrombosis formation after transvenous permanent pacemaker implantation. Further prospective study will be needed to a ssess the efficacy of prophylactic administration of anticoagulant and antiaggregant drugs.