Key result
Literature analysis indicates that placement of endocardial electrodes during pacemaker implantation leads to activation of the coagulation system, highlighting the need for further research.
Why the study?
Endocardial electrode placement activates the coagulation system, but more in-depth research is needed to understand the specific phase of coagulation cascade changes, their persistence, and ways to prevent or modulate them.
Does permanent pacemaker implantation lead to changes in coagulation parameters and increased risk of thrombosis?
Does permanent pacemaker implantation lead to changes in coagulation parameters and increased risk of thrombosis?
Permanent pacemaker implantation is associated with activation of the coagulation system, highlighting the need for further research on modulating these prothrombotic changes.
May signal elevated periprocedural thrombosis risk; leaves open whether modulating coagulation improves outcomes.
The connection between venous thrombotic events in patients with implanted pacemakers and changes in coagulation factors has been the basis of numerous scientific studies for years. Results show that the effect on the coagulation system is a long-term and dynamic process, as well as presence of a significant dependence with many concomitant cardiovascular diseases. Advances in medicine in recent decades and increase in life expectancy of patients with implanted cardiac devices (ICD) increase the risk of a variety of complications. These adverse events may be associated with development of thrombosis, change in the stimulation threshold, need for ablation due to concomitant rhythm pathology and others. Analysis of data from literature shows unequivocally that placement of endocardial electrodes leads to activation of the coagulation system in the body. On the one hand, this is a result of the direct traumatic moment and endothelial damage in the early post-procedure period, and subsequently, the presence of electrodes of the foreign body type in some individuals can provoke a procoagulation state. More in-depth research is needed in this area to clarify the answers to these questions, namely: in which phase of the coagulation cascade are the changes most significant; is there a way to anticipate these changes and prevent them accordingly; is disturbed homeostasis of coagulation temporary or persistent. These questions will be answered after sufficient data have been accumulated on these changes and how to modulate them.
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Yoncheva et al. (2020) conducted a review in Venous thrombotic events in patients with implanted pacemakers. Permanent pacemaker implantation was evaluated on Changes in coagulation parameters. Literature analysis indicates that placement of endocardial electrodes during pacemaker implantation leads to activation of the coagulation system, highlighting the need for further research.
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