Deep Venous Thrombosis of Upper Extremities After Implantation of Cardiac Pacemaker: Analysis of the Risk Factors, Treatment and Secondary Prevention_Chinese Journal of Evidence-Based Medicine

Authors：

LI Jun , WANG Shuang , DONG Birong

Department of Geriatrics; West China Hospital; Sichuan University; Chengdu 610041; China;

Corresponding author：

Keywords：

Deep venous thrombosis; Risk factors; Evidence-based treatment; Secondary prevention

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Little has been reported about deep venous thrombosis (DVT) that occurs after the implantation of the cardiac pacemaker. DVT affects the prognosis and quality of life of patients severely, or even causes fatal pulmonary embolism. Research on its risk factors, therapeutic strategy and secondary prevention does not coincide with one another. We have searched the systematic reviews and randomized controlled trials of DVT through PubMed, Cochrane Library and Guideline. Evidence has showed that previous DVT, over 40 years of age, and surgical history are the major risk factors. Initial treatment of DVT with heparin and maintenance therapy with oral anticoagulant are indispensable and effective, and could improve the prognosis of patients. If patients with previous DVT are at increased risk in the future, heparin and / or oral anticoagulant application may be used for prophylaxis.

Citation： LI Jun,WANG Shuang,DONG Birong. Deep Venous Thrombosis of Upper Extremities After Implantation of Cardiac Pacemaker: Analysis of the Risk Factors, Treatment and Secondary Prevention. Chinese Journal of Evidence-Based Medicine, 2004, 04(9): 652-656. doi: Copy

1.	［1］Scottish Intercollegiate Guidelines Network (SIGN). Prophylaxis of venous thromboembolism. A national clinical guideline. Edinburgh (Scotland): Scottish Intercollegiate Guidelines Network (SIGN); 2002. 47.
2.	［2］Geerts WH, Heit JA, Clagett GP, Pineo GF, Colwell CW, Anderson FA Jr, Wheeler HB. Prevention of venous thromboembolism[J]. Chest, 2001; 119(1 Suppl): 132S-175S.
3.	［3］Hansson PO, Eriksson H, Welin L, Svardsudd K, Wilhelmsen L. Smoking and abdominal obesity: risk factors for venous thromboembolism among middle-aged men: "the study of men born in 1913"[J]. Arch Intern Med, 1999; 159(16): 1 886-1 890.
4.	［4］The Standards Task Force of the American Society of Colon and Rectal Surgeons. Practice parameters for the prevention of venous thromboembolism[J]. Dis Colon Rectum, 2000; 43(8): 1 037-1 047.
5.	［5］Finnish Medical Society Duodecim. Edotpr-in-Chief Deep venous thrombosis[M]. Helsinki, Finland: Duodecim Medical Publications Ltd.; 2002. Various p.
6.	［6］The Database of Abstracts of Reviews of Effectiveness (University of York), Database No.: DARE-981801[M/CD]. In: The Cochrane Library, Issue 2, 2000. Oxford: Update Software.
7.	［7］Antithrombotic therapy. A national clinical guideline. Edin-burgh (Scotland): Scottish Intercollegiate Guidelines Network (SIGN); 1999. 70.
8.	［8］Dolovich L, Ginsberg JS. Low molecular weight heparin in the treatment of venous thromboembolism: an updated meta-analysis[J]. Vessels, 1997; 3(1): 4-11.
9.	［9］Van den Belt AGM, Prins MH, Lensing AWA, Castro AA, Clark OAC, Atallah AN, Burihan E. Fixed dose subcutaneous low molecular weight heparins versus adjusted dose unfractionated heparin for venous thromboembolism (Cochrane Review) [M/CD]. In: The Cochrane Library, Issue 1, 2003. Oxford: Update Software.
10.	［10］Hirsh J, Fuster V, Ansell J, Halperin JL; American Heart As-sociation; American College of Cardiology Foundation. American Heart Association/American College of Cardiology Foundation guide to warfarin therapy[J]. Circulation, 2003; 107(12): 1 692-1 711.
11.	［11］Hull RD, Delmore T, Carter C, Hirsh J, Genton E, Gent M, Turpie G, McLaughlin D. Adjusted subcutaneous heparin versus warfarin sodium in the long-term treatment of venous thrombosis[J]. N Engl J Med, 1982; 306(4): 189-194.
12.	［12］Ansell J, Hirsh J, Dalen J, Bussey H, Anderson D, Poller L, Jacobson A, Deykin D, Matchar D. Managing oral anticoagulant therapy[J]. Chest, 2001; 119(1 Suppl): 22S-38S.
13.	［13］Pinede L, Duhaut P, Cucherat M, Ninet J, Pasquier J, Boissel JP. Comparison of long versus short duration of anticoagulant therapy after a first episode of venous thromboembolism: a meta-analysis of randomized, controlled trials[J]. Journal of Internal Medicine, 2000; 247(5): 553-562.
14.	［14］Schulman S, Granqvist S, Holmstrom M, Carlsson A, Lindmarker P, Nicol P, Eklund SG, Nordlander S, Larfars G, Leijd B, Linder O, Loogna E. The duration of oral anticoagulant therapy after a second episode of venous thromboembolism: Duration of Anticoagulation Trial Study Group[J]. N Engl J Med, 1997; 336(6): 393-398.
15.	［15］Scottish Intercollegiate Guidelines Network (SIGN). Prophylaxis of venous thromboembolism. Edinburgh: SIGN 1995. (SIGN publication no. 2).
16.	［16］Meyer G, Marjanovic Z, Valcke J, Lorcerie B, Gruel Y, Solal-Celigny P, Le Maignan C, Extra JM, Cottu P, Farge D. Comparison of low-molecular-weight heparin and warfarin for the secondary prevention of venous thromboembolism in patients with cancer: a randomized controlled study[J]. Arch Intern Med, 2002; 162(15): 1 729-1 735.
17.	［17］Samama MM. Epidemiology of risk factors of deep venous thrombosis(DVT) of the lower limbs in community practice: the SIRIUS study[J]. Thromb Haemost, 1993; 69(6): 763.
18.	［18］Hyers TM, Hull RD, Weg JG. Antithrombotic therapy for venous thromboembolic disease[J]. Chest, 1995; 108(4 Suppl): 335S-351S.
19.	［19］Brandjes DP, Heijboer H, Buller HR, de Rijk M, Jagt H, ten Cate JW. Acenocoumarol and heparin compared with acenocoumarol alone in the initial treatment of proximal-vein thrombosis[J]. N Engl J Med, 1992; 327(21): 1 485-1 489.
20.	［20］Monreal M. Long-term treatment of venous thromboembolism: the place of low molecular weight heparin[J]. Vessels, 1997; 3(1): 18-21.
21.	［21］Mohiuddin SM, Hilleman DE, Destache CJ, Stoysich AM, Gannon JM, Sketch MH Sr. Efficacy and safety of early versus late initiation of warfarin during heparin therapy in acute thromboembolism[J]. Am Heart J, 1992; 123(3): 729-732.
22.	［22］Schulman S, Lockner D. Relationship between thromboembolic complications and intensity of treatment during long term prophylaxis with oral anticoagulants following DVT[J]. Thromb Haemost, 1985; 53(1): 137-140.
23.	［23］Harrison L, Johnston M, Massicotte MP, Crowther M, Moffat K, Hirsh J. Comparison of 5-mg and 10-mg loading dose in initiation of warfarin therapy[J]. Ann Intern Med, 1997; 126(2): 133-136.
24.	［24］Schulma S, Svenungsson E, Granqvist S. Anticardiolipin antibodies predict early recurrence of thromboembolism following anticoagulant therapy: Duration of Anticoagulation Study Group[J]. Am J Med, 1998; 104(4): 332-338.
25.	［25］Rance A, Emmerich J, Fiessinger JN. Anticardiolipin antibodies and recurrent thromboembolism[J]. Thromb Haemost, 1997; 77(1): 221-222.

1. ［1］Scottish Intercollegiate Guidelines Network (SIGN). Prophylaxis of venous thromboembolism. A national clinical guideline. Edinburgh (Scotland): Scottish Intercollegiate Guidelines Network (SIGN); 2002. 47.
2. ［2］Geerts WH, Heit JA, Clagett GP, Pineo GF, Colwell CW, Anderson FA Jr, Wheeler HB. Prevention of venous thromboembolism[J]. Chest, 2001; 119(1 Suppl): 132S-175S.
3. ［3］Hansson PO, Eriksson H, Welin L, Svardsudd K, Wilhelmsen L. Smoking and abdominal obesity: risk factors for venous thromboembolism among middle-aged men: "the study of men born in 1913"[J]. Arch Intern Med, 1999; 159(16): 1 886-1 890.
4. ［4］The Standards Task Force of the American Society of Colon and Rectal Surgeons. Practice parameters for the prevention of venous thromboembolism[J]. Dis Colon Rectum, 2000; 43(8): 1 037-1 047.
5. ［5］Finnish Medical Society Duodecim. Edotpr-in-Chief Deep venous thrombosis[M]. Helsinki, Finland: Duodecim Medical Publications Ltd.; 2002. Various p.
6. ［6］The Database of Abstracts of Reviews of Effectiveness (University of York), Database No.: DARE-981801[M/CD]. In: The Cochrane Library, Issue 2, 2000. Oxford: Update Software.
7. ［7］Antithrombotic therapy. A national clinical guideline. Edin-burgh (Scotland): Scottish Intercollegiate Guidelines Network (SIGN); 1999. 70.
8. ［8］Dolovich L, Ginsberg JS. Low molecular weight heparin in the treatment of venous thromboembolism: an updated meta-analysis[J]. Vessels, 1997; 3(1): 4-11.
9. ［9］Van den Belt AGM, Prins MH, Lensing AWA, Castro AA, Clark OAC, Atallah AN, Burihan E. Fixed dose subcutaneous low molecular weight heparins versus adjusted dose unfractionated heparin for venous thromboembolism (Cochrane Review) [M/CD]. In: The Cochrane Library, Issue 1, 2003. Oxford: Update Software.
10. ［10］Hirsh J, Fuster V, Ansell J, Halperin JL; American Heart As-sociation; American College of Cardiology Foundation. American Heart Association/American College of Cardiology Foundation guide to warfarin therapy[J]. Circulation, 2003; 107(12): 1 692-1 711.
11. ［11］Hull RD, Delmore T, Carter C, Hirsh J, Genton E, Gent M, Turpie G, McLaughlin D. Adjusted subcutaneous heparin versus warfarin sodium in the long-term treatment of venous thrombosis[J]. N Engl J Med, 1982; 306(4): 189-194.
12. ［12］Ansell J, Hirsh J, Dalen J, Bussey H, Anderson D, Poller L, Jacobson A, Deykin D, Matchar D. Managing oral anticoagulant therapy[J]. Chest, 2001; 119(1 Suppl): 22S-38S.
13. ［13］Pinede L, Duhaut P, Cucherat M, Ninet J, Pasquier J, Boissel JP. Comparison of long versus short duration of anticoagulant therapy after a first episode of venous thromboembolism: a meta-analysis of randomized, controlled trials[J]. Journal of Internal Medicine, 2000; 247(5): 553-562.
14. ［14］Schulman S, Granqvist S, Holmstrom M, Carlsson A, Lindmarker P, Nicol P, Eklund SG, Nordlander S, Larfars G, Leijd B, Linder O, Loogna E. The duration of oral anticoagulant therapy after a second episode of venous thromboembolism: Duration of Anticoagulation Trial Study Group[J]. N Engl J Med, 1997; 336(6): 393-398.
15. ［15］Scottish Intercollegiate Guidelines Network (SIGN). Prophylaxis of venous thromboembolism. Edinburgh: SIGN 1995. (SIGN publication no. 2).
16. ［16］Meyer G, Marjanovic Z, Valcke J, Lorcerie B, Gruel Y, Solal-Celigny P, Le Maignan C, Extra JM, Cottu P, Farge D. Comparison of low-molecular-weight heparin and warfarin for the secondary prevention of venous thromboembolism in patients with cancer: a randomized controlled study[J]. Arch Intern Med, 2002; 162(15): 1 729-1 735.
17. ［17］Samama MM. Epidemiology of risk factors of deep venous thrombosis(DVT) of the lower limbs in community practice: the SIRIUS study[J]. Thromb Haemost, 1993; 69(6): 763.
18. ［18］Hyers TM, Hull RD, Weg JG. Antithrombotic therapy for venous thromboembolic disease[J]. Chest, 1995; 108(4 Suppl): 335S-351S.
19. ［19］Brandjes DP, Heijboer H, Buller HR, de Rijk M, Jagt H, ten Cate JW. Acenocoumarol and heparin compared with acenocoumarol alone in the initial treatment of proximal-vein thrombosis[J]. N Engl J Med, 1992; 327(21): 1 485-1 489.
20. ［20］Monreal M. Long-term treatment of venous thromboembolism: the place of low molecular weight heparin[J]. Vessels, 1997; 3(1): 18-21.
21. ［21］Mohiuddin SM, Hilleman DE, Destache CJ, Stoysich AM, Gannon JM, Sketch MH Sr. Efficacy and safety of early versus late initiation of warfarin during heparin therapy in acute thromboembolism[J]. Am Heart J, 1992; 123(3): 729-732.
22. ［22］Schulman S, Lockner D. Relationship between thromboembolic complications and intensity of treatment during long term prophylaxis with oral anticoagulants following DVT[J]. Thromb Haemost, 1985; 53(1): 137-140.
23. ［23］Harrison L, Johnston M, Massicotte MP, Crowther M, Moffat K, Hirsh J. Comparison of 5-mg and 10-mg loading dose in initiation of warfarin therapy[J]. Ann Intern Med, 1997; 126(2): 133-136.
24. ［24］Schulma S, Svenungsson E, Granqvist S. Anticardiolipin antibodies predict early recurrence of thromboembolism following anticoagulant therapy: Duration of Anticoagulation Study Group[J]. Am J Med, 1998; 104(4): 332-338.
25. ［25］Rance A, Emmerich J, Fiessinger JN. Anticardiolipin antibodies and recurrent thromboembolism[J]. Thromb Haemost, 1997; 77(1): 221-222.

Chinese Journal of Evidence-Based Medicine

Deep Venous Thrombosis of Upper Extremities After Implantation of Cardiac Pacemaker: Analysis of the Risk Factors, Treatment and Secondary Prevention

Abstract Full text Figures/Tables Video References Cited by

Format

Content