Cc. De Cock et al., Long-term outcome of patients with multiple (>= 3) noninfected transvenousleads: A clinical and echocardiographic study, PACE, 23(4), 2000, pp. 423-426
Citations number
14
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
To prospectively assess the incidence and clinical significance of thromboe
mbolic complications in patients with multiple (greater than or equal to 3)
noninfected transvenous leads; 48 consecutive patients were evaluated. Hal
f of the patients had two ventricular leads and one atrial lead, 15 patient
s had two atrial leads and one ventricular lead, while 9 patients had two v
entricular and two atrial leads. No additional care was provided except for
aspirin (80 mg bid) and annually performed echo-Doppler studies. Clinical
follow-up included signs and symptoms of subclavian and/or axillary vein th
rombosis, the presence of right congestive heart failure, the number of hos
pital admissions, and death. Echo-Doppler studies assessed the presence of
an enlarged right atrium or ventricle, right atrial or ventricular spontane
ous contrast, and the presence of tricuspid regurgitation. During a total f
ollow-up of 7.4 +/- 2.2 years there were no differences in the incidence of
clinical variables as compared to age-matched controls with DDD pacemakers
. The most common complication was transient venous thrombosis (mostly pres
enting as venous prominence 1-2 weeks after implantation), which was seen i
n 17% of the study group versus 15% in controls (NS). Cumulative mortality
was not different in both groups (13% in the study group vs 15% in controls
). No differences were present with respect to hospital admissions (1.1 +/-
0.27/year in the study group vs 1.2 +/- 0.30/year in the controls). In pat
ients with multiple ventricular leads, tricuspid regurgitation on echo-Dopp
ler studies was more frequent (24%) as compared to controls (4%); however,
clinical signs of right heart failure were equally distributed. Thus, patie
nts with multiple (greater than or equal to 3) noninfected leads have no cl
inical adverse outcome during long-term follow-up.