Long-term outcome of patients with multiple (> or = 3) noninfected transvenous leads: a clinical and echocardiographic study

Pacing Clin Electrophysiol. 2000 Apr;23(4 Pt 1):423-6. doi: 10.1111/j.1540-8159.2000.tb00821.x.


To prospectively assess the incidence and clinical significance of thromboembolic complications in patients with multiple (> or = 3) noninfected transvenous leads; 48 consecutive patients were evaluated. Half of the patients had two ventricular leads and one atrial lead, 15 patients had two atrial leads and one ventricular lead, while 9 patients had two ventricular and two atrial leads. No additional care was provided except for aspirin (80 mg bid) and annually performed echo-Doppler studies. Clinical follow-up included signs and symptoms of subclavian and/or axillary vein thrombosis, the presence of right congestive heart failure, the number of hospital admissions, and death. Echo-Doppler studies assessed the presence of an enlarged right atrium or ventricle, right atrial or ventricular spontaneous contrast, and the presence of tricuspid regurgitation. During a total follow-up of 7.4 +/- 2.2 years there were no differences in the incidence of clinical variables as compared to age-matched controls with DDD pacemakers. The most common complication was transient venous thrombosis (mostly presenting as venous prominence 1-2 weeks after implantation), which was seen in 17% of the study group versus 15% in controls (NS). Cumulative mortality was not different in both groups (13% in the study group vs 15% in controls). No differences were present with respect to hospital admissions (1.1 +/- 0.27/year in the study group vs 1.2 +/- 0.30/year in the controls). In patients with multiple ventricular leads, tricuspid regurgitation on echo-Doppler studies was more frequent (24%) as compared to controls (4%); however, clinical signs of right heart failure were equally distributed. Thus, patients with multiple (> or = 3) noninfected leads have no clinical adverse outcome during long-term follow-up.

Publication types

  • Comparative Study

MeSH terms

  • Catheterization, Peripheral*
  • Echocardiography, Doppler*
  • Electrodes, Implanted* / adverse effects
  • Endocardium / diagnostic imaging
  • Follow-Up Studies
  • Heart Atria / diagnostic imaging
  • Heart Failure / diagnostic imaging
  • Heart Failure / epidemiology
  • Heart Failure / etiology
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Incidence
  • Middle Aged
  • Pacemaker, Artificial* / adverse effects
  • Prognosis
  • Prospective Studies
  • Prosthesis Failure*
  • Survival Rate
  • Tachycardia / therapy*
  • Tricuspid Valve Insufficiency / diagnostic imaging
  • Tricuspid Valve Insufficiency / epidemiology
  • Tricuspid Valve Insufficiency / etiology
  • Venous Thrombosis / epidemiology
  • Venous Thrombosis / etiology