Prevalence of central venous occlusion in patients with chronic defibrillator leads

Christian Sticherling, Steven P. Chough, Robert L. Baker, Kristina Wasmer, Hakan Oral, Hiroshi Tada, Laura Horwood, Michael H. Kim, Frank Pelosi, Gregory F. Michaud, S. Adam Strickberger, Fred Morady, Bradley P. Knight*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

89 Scopus citations

Abstract

Background: Many patients with previously implanted ventricular defibrillators are candidates for an upgrade to a device capable of atrial-ventricular sequential or multisite pacing. The prevalence of venous occlusion after placement of transvenous defibrillator leads is unknown. The purpose of this study was to determine the prevalence of central venous occlusion in asymptomatic patients with chronic transvenous defibrillator leads. Methods: Thirty consecutive patients with a transvenous defibrillator lead underwent bilateral contrast venography of the cephalic, axillary, subclavian, and brachiocephalic veins as well as the superior vena cava before an elective defibrillator battery replacement. The mean time between transvenous defibrillator lead implantation and venography was 45 ± 21 months. Sixteen patients had more than 1 lead in the same subclavian vein. No patient had clinical signs of venous occlusion. Results: One (3%) patient had a complete occlusion of the subclavian vein, 1 (3%) patient had a 90% subclavian vein stenosis, 2 (7%) patients had a 75% to 89% subclavian stenosis, 11 (37%) patients had a 50% to 74% subclavian stenosis, and 15 (50%) patients had no subclavian stenosis. Conclusions: The low prevalence of subclavian vein occlusion or severe stenosis among defibrillator recipients found in this study suggests that the placement of additional transvenous leads in a patient who already has a ventricular defibrillator is feasible in a high percentage of patients (93%).

Original languageEnglish (US)
Pages (from-to)813-816
Number of pages4
JournalAmerican heart journal
Volume141
Issue number5
DOIs
StatePublished - 2001

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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