Relationship Between Changes in Selected Thrombotic and Inflammatory Factors, Echocardiographic Parameters and the Incidence of Venous Thrombosis After Pacemaker Implantation Based on Our Own Observations

Overview

Journal Arch Med Sci

Specialty General Medicine

Date 2013 Jan 16

PMID 23319977

Citations 1

Authors

Jacek Lelakowski

Teresa Barbara Domagala

Anna Rydlewska

Rafal Januszek

Katarzyna Kotula-Horowitz

Jacek Majewski

Andrzej Zabek

Barbara Malecka

Affiliations

Soon will be listed here.

Abstract

Introduction: Thrombosis (VTh) is a rare dangerous complication of pacemaker implantation (PM). The aim of the study was to determine the dynamics of change in selected thrombotic and inflammatory factors after PM.

Material And Methods: The study involved 81 patients (30 female, mean age: 71.1 years) with PM, divided into two groups. Group A (71 patients) consisted of patients without VTh, whereas group B (10 patients) comprised the patients with VTh. A transthoracic echocardiogram (TTE) and a venous ultrasound (VU) examination were performed. The levels of D-dimers, fibrinogen, tissue factor (TF), factor VII, plasminogen activator inhibitor-1 (PAI-1), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) were determined in the venous blood. After PM, the TTE and VU examinations were repeated at 6 and 12 months, and blood analyses were performed within 7 days after PM, and subsequently at 6 and 12 months.

Results: In 10 patients of group B, symptomatic VTh occurred at a mean time of 13.06 months after PM. Initially, the levels of IL-6, hsCRP, D-dimers, fibrinogen, TF, VII factor and PAI-1 were considerably higher in group B than in group A. In all patients the levels of these factors kept on increasing for up to 7 days after the procedure. In group A they subsequently decreased, whereas in group B they continued to rise.

Conclusions: Increased levels of inflammatory and thrombotic factors were observed in patients with VTh before and after PM. The factors of highest risk of VTh occurrence were D-dimers, fibrinogen and TF.

Citing Articles

Swine Model of Thrombotic Caval Occlusion Created by Autologous Thrombus Injection with Assistance of Intra-caval Net Knitting.

Shi W, Wu S, Hu L, Liu C, Gu J Sci Rep. 2015; 5:18546.

PMID: 26680253 PMC: 4683581. DOI: 10.1038/srep18546.

References

Goudevenos J, Reid P, Adams P, Holden M, WILLIAMS D . Pacemaker-induced superior vena cava syndrome: report of four cases and review of the literature. Pacing Clin Electrophysiol. 1989; 12(12):1890-5. DOI: 10.1111/j.1540-8159.1989.tb01881.x. View

Bielecka-Dabrowa A, Wierzbicka M, Goch J . [Proinflammatory cytokines in cardiovascular diseases as potential therapeutic target]. Wiad Lek. 2008; 60(9-10):433-8. View

Neuwirth J, BOHUTOVA J, Kolar J, Kautzner J, Novak M . DSA diagnosis of pulmonary embolization from intracardial thrombus in a patient with permanent pacing catheter. Pacing Clin Electrophysiol. 1990; 13(1):7-10. DOI: 10.1111/j.1540-8159.1990.tb01996.x. View

Oginosawa Y, Abe H, Nakashima Y . The incidence and risk factors for venous obstruction after implantation of transvenous pacing leads. Pacing Clin Electrophysiol. 2002; 25(11):1605-11. DOI: 10.1046/j.1460-9592.2002.01605.x. View

Rozmus G, Daubert J, Huang D, Rosero S, Hall B, Francis C . Venous thrombosis and stenosis after implantation of pacemakers and defibrillators. J Interv Card Electrophysiol. 2005; 13(1):9-19. DOI: 10.1007/s10840-005-1140-1. View

Lelakowski J, Rydlewska A, Domagala T, Piekarz J, Karkowski G, Januszek R . [Venous thrombosis as a complication of pacemaker implantation--own observations]. Pol Merkur Lekarski. 2011; 30(176):102-10. View

Mazzetti H, DUSSAUT A, Tentori C, DUSSAUT E, Lazzari J . Superior vena cava occlusion and/or syndrome related to pacemaker leads. Am Heart J. 1993; 125(3):831-7. DOI: 10.1016/0002-8703(93)90178-c. View

Walczak B, Demkow U, Fijalkowska A . [Methods of estimating concentration of the D-dimers used in venous thromboembolism diagnosis]. Pneumonol Alergol Pol. 2009; 77(3):264-70. View

Iskra T, Turaj W, Slowik A, Zwolinska G, Strojny J, Szczudlik A . [Hemostatic markers of endothelial injury in ischaemic stroke caused by large or small vessel disease]. Pol Merkur Lekarski. 2007; 21(125):429-33. View

10.

Lelakowski J, Majewski J, Zabek A, Malecka B, Kuniewicz M, Kafara M . [Venous thrombosis as a clinical problem after pacemaker implantation--case report]. Pol Merkur Lekarski. 2010; 29(169):41-3. View

11.

Banach M, Markuszewski L, Zaslonka J, Grzegorczyk J, Okonski P, Jegier B . [The role of inflammation in the pathogenesis of atherosclerosis]. Przegl Epidemiol. 2005; 58(4):663-70. View

12.

Ito T, Tanouchi J, Kawabata M, Tanaka K, Miyawaki M, Kato J . Superior vena cava syndrome due to a permanent transvenous pacing lead. Jpn Circ J. 1996; 60(9):707-9. DOI: 10.1253/jcj.60.707. View

13.

Kotschy M, Kotschy D, Witkiewicz W . [The role of tissue factor and tissue factor pathway inhibitor in blood coagulation and in thrombotic complications]. Kardiol Pol. 2010; 68(10):1158-62. View

14.

Zabczyk M, Butenas S, Palka I, Nessler J, Undas A . Active tissue factor and activated factor XI in circulating blood of patients with systolic heart failure due to ischemic cardiomyopathy. Pol Arch Med Wewn. 2010; 120(9):334-40. PMC: 3168988. View

15.

Ravyts M, Hermans K, Stockman D . Superior vena cava syndrome and infection of pacing leads in one patient. Acta Cardiol. 2002; 57(4):309-11. DOI: 10.2143/AC.57.4.2005433. View

16.

Bracke F, Meijer A, van Gelder L . Pacemaker lead complications: when is extraction appropriate and what can we learn from published data?. Heart. 2001; 85(3):254-9. PMC: 1729652. DOI: 10.1136/heart.85.3.254. View

17.

Swinkels B, Ophuis A, Zegers E, Hertzberger D, Meursing B . Recurrent pacemaker lead induced axillary subclavian vein thrombosis. Pacing Clin Electrophysiol. 2001; 24(5):910-1. DOI: 10.1046/j.1460-9592.2001.00910.x. View

18.

Martinez-Selles M, Bueno H, Almendral J . Pulmonary embolism after pacemaker implantation. Tex Heart Inst J. 2002; 28(4):318-9. PMC: 101212. View

19.

Korkeila P, Nyman K, Ylitalo A, Koistinen J, Karjalainen P, Lund J . Venous obstruction after pacemaker implantation. Pacing Clin Electrophysiol. 2007; 30(2):199-206. DOI: 10.1111/j.1540-8159.2007.00650.x. View

20.

Barakat K, Robinson N, Spurrell R . Transvenous pacing lead-induced thrombosis: a series of cases with a review of the literature. Cardiology. 2000; 93(3):142-8. DOI: 10.1159/000007018. View