Short-term Venous Patency after Implantation of Permanent Pacemakers or Implantable Cardioverter Defibrillators

There is little information on venous patency after pacing leads are inserted in veins during pacemaker or implantable cardioverter defibrillator (ICD) implantation. Herein we present a report on venous patency during the immediate postoperative period after permanent pacemaker or ICD implantation. Subjects and Methods: Twenty-five patients underwent a permanent pacemaker or ICD implantation by venous puncture method, and venography was performed 1 week later. We assessed the pacemaker-implantation side, approach used, implanted device, number of implanted leads, and clinical symptoms. Results: Narrowing of the vein was found in 14 patients (56%), including 7 patients (28%) with occlusion. Stenosis and occlusion were seen more in patients with left-sided implantation than those with right-sided implantation (71% vs. 25%, P < 0.05). ICD implantation was more frequently associated with venous stenosis or occlusion than pacemaker implantation (65% vs. 37.5%, P < 0.05). The approach used and the number of leads implanted did not correlate with venous stenosis or occlusion. Six of the 7 patients who developed complete occlusion showed clinical symptoms. Conclusion: Thrombus formation after pacemaker implantation can occur in the acute stage within 1 week. The incidence of venous stenosis or thrombus formation was higher with leftsided implantation and ICD.