Risk Factors of Upper Extremity Deep Vein Thrombosis After Pacemaker Implantation

Objective. To evaluate the prevalence, risk factors and treatment outcomes of upper extremity deep vein thrombosis after pacemaker implantation. Material and methods. A prospective single-center study included patients with indications for pacemaker implantation. The follow-up period was 12 months. Physical examination, ultrasound of upper and lower extremity veins and monitoring of pacemaker function were carried out before implantation, 1 and 12 months later. Additional ultrasound was necessary for treatment control in case of upper extremity deep vein thrombosis. Results. There were 148 patients. Venous thromboembolism occurred in 10 (6.8%) cases throughout the follow-up period: 8 (5.4%) cases of subclavian vein thrombosis and 2 (1.4%) cases of superficial thrombophlebitis of lower extremities. According to multivariate analysis, the odds ratio of upper extremity deep vein thrombosis was 6.4 times (p=0.033) higher in patients receiving antiplatelet agents (acetylsalicylic acid) compared to anticoagulants. Treatment of venous thrombosis implied rivaroxaban. In 5 out of 6 patients, vein recanalization was achieved within 3 months, in 1 case — within 12 months. One patient had subconjunctival hemorrhage that required short-term discontinuation of anticoagulation without effect on baseline result. Conclusion. Annual incidence of venous thromboembolism after pacemaker implantation was 6.8%. Risk factor of upper extremity deep vein thrombosis was the type of antithrombotic therapy.