Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 1, January-February, p. 83–91

doi: 10.17219/acem/42317

Publication type: original article

Language: English

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Venous Stenosis and Occlusion in the Presence of Endocardial Leads

Krzysztof Boczar1,A,B,C,D, Andrzej Ząbek1,B,C, Kazimierz Haberka1,2,B, Małgorzata Hardzina1,B, Maciej Dębski1,B,D, Anna Rydlewska1,B, Ewa Nowosielska-Ząbek3,B, Jacek Lelakowski1,2,F, Barbara Małecka1,2,A,C,E

1 Department of Electrocardiology, John Paul II Hospital, Kraków, Poland

2 Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland

3 Outpatient Clinic, Scanmed Multimedis, Kraków, Poland

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.
Objectives. 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.
Material and 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).
Conclusion. 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.

Key words

complications, pacemaker, venous stenosis, venous occlusion, venography

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