Bulur Serkan, Vural Ahmet, Yazıcı Mehmet, Ertaş Gökhan, Özhan Hakan, Ural Dilek
Department of Cardiology, Medicine Faculty, Duzce University, Duzce, Turkey.
J Interv Card Electrophysiol. 2010 Dec;29(3):199-202. doi: 10.1007/s10840-010-9516-2. Epub 2010 Oct 2.
The data about the incidence of subclavian venous (SCV) obstruction or thrombosis after biventricular device implantation is limited. Therefore, we aimed to assess the incidence and predictors of venous obstruction after biventricular device implantation with or without a defibrillator in patients with left ventricular systolic dysfunction and cardiac dyssynchrony.
Eighty-six patients who had undergone biventricular device implantation were included in the study. Subclavian vein was patent in 61% of all participants. Among the patients with subclavian obstruction (n = 33), 8 had mild obstruction, 15 had severe obstruction, and 10 had total occlusion. The presence of additional implantable cardioverter defibrillator (ICD) and the number of leads that were used were found to be significant covariates of obstruction in subclavian vein after biventricular device implantation (p = 0.004 and p = 0.01, respectively). Atrial fibrillation after biventricular pacemaker and ICD implantation was significantly related with total occlusion (r = 0.3, p = 0.005 and r = 0.24, p = 0.003, respectively).
Patients who are candidates for biventricular device implantation are at increased risk for venous obstruction when compared with other pacemaker patients and this causes higher incidence of venous obstruction among these patients.
关于双心室装置植入术后锁骨下静脉（SCV）梗阻或血栓形成发生率的数据有限。因此，我们旨在评估左心室收缩功能障碍和心脏不同步的患者在植入有或无除颤器的双心室装置后静脉梗阻的发生率及预测因素。
本研究纳入了86例行双心室装置植入术的患者。所有参与者中61%的锁骨下静脉通畅。在锁骨下静脉梗阻患者（n = 33）中，8例为轻度梗阻，15例为重度梗阻，10例为完全闭塞。发现额外植入式心脏复律除颤器（ICD）的存在以及使用的导线数量是双心室装置植入术后锁骨下静脉梗阻的显著协变量（分别为p = 0.004和p = 0.01）。双心室起搏器和ICD植入术后的心房颤动与完全闭塞显著相关（分别为r = 0.3，p = 0.005和r = 0.24，p = 0.003）。
与其他起搏器患者相比，双心室装置植入术候选患者发生静脉梗阻的风险增加，这导致这些患者中静脉梗阻的发生率更高。
