Abstract
Aims: Venous obstruction following cardiac electronic device implantation sometimes causes a challenge in lead revision or device upgrade. The aim of this study was to determine the predictors of venous obstruction after transvenous device implantation. Methods and Results: Between April 2004 and April 2011, contrast venography was performed in 77 patients who needed lead revision or device upgrade. Sixteen (21%) of them had venous obstruction, including 8 patients with total obstruction and 8 patients with partial obstruction. No significant differences between obstructed and non-obstructed patients were seen for age, sex, atrial fibrillation, dilated cardiomyopathy, numbers of the leads, antiplatelet/anticoagulant drugs, and time from initial implantation to lead revision or device upgrade. In univariate analysis, low body weight and low body surface area (BSA) were associated with an increased risk of venous obstruction (P=0.036, 55.4 vs 62.3 kg, and P=0.035, 1.57 vs 1.68 m2, respectively). Multivariate logistic regression analysis showed that BSA was a predictor of venous obstruction (OR: 0.58, 95% CI: 0.36–0.96, P=0.034). This means 1.7-fold risk of venous obstruction per 0.1 m2 decrease of BSA. Conclusion: The incidence of venous obstruction following cardiovascular electronic device implantation was not rare. In this study, BSA had negative correlation with risk of venous obstruction.
