An abnormal flow profile of Internal Jugular Vein in Patients Implanted with Pacemaker-leads

Background ; Pacemaker (PM)-lead-induced venous thrombosis is a rare but serious complication. Its early detection is diagnostic challenge. Lead-induced venous thrombosis causes internal jugular vein (IJV) engorgement, but little attention was given to the IJV blood flow pattern. Our aim was to characterize the IJV flow profile of patients with PM-leads, and to identify the risk factors of the lead-induced venous thrombosis by using IJV stasis as a surrogate marker. Method & Results ; 43 patients implanted with PM-leads were studied. Blood stasis of left IJV was found in 20 of 43 (47%), in which spontaneous echo contrast was observed in all patients with IVJ stasis. According to the ultrasound based IJV flow pattern, patients were classified into two groups ; no-stasis group and stasis group. Average number of implanted leads in stasis group was significantly higher than that in no-stasis group (2.39±0.10 vs. 2.75±0.12, P=0.0304). Although Hb, D-dimer levels and right ventricular function were unrelated, the reduced left ventricular ejection fraction (LVEF) had an association with findings of IJV stasis.Conclusions ; The number of PM-leads relates to the occurrence of IJV stasis. Additionally, the reduced LVEF could be a causative factor for IJV stasis in patients with PM-lead