Transvenous Pacing

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Robert M Gow - One of the best experts on this subject based on the ideXlab platform.

  • Risk Factors for Venous Obstruction in Children with Transvenous Pacing Leads
    Pacing and Clinical Electrophysiology, 1997
    Co-Authors: Felicia H Figa, Jeanluc Bigras, Brian W Mccrindle, Robert M Hamilton, Robert M Gow
    Abstract:

    To determine the incidence and risk factors for venous obstruction in children with Transvenous Pacing leads, 63 children were evaluated clinically and echocardiographically. Patients with abnormal clinical and/or echocardiographic findings were further investigated by venography. Thirteen patients (21%) had evidence of venous obstruction. Venography in 11 (2 refused) showed that severity of obstruction (as defined by percentage of luminal narrowing) was complete (100%) in 3, severe (> 90%) in 4, and moderate (60%-90%) in 5 (1 patient having 2 sites of obstruction). Risk factors for obstruction in 55 patients with single implantation procedures (10 with obstruction; 18%) were sought. Total cross-sectional area of lead(s) was indexed to body surface area at implantation (INDEX). Patients with obstruction had a higher mean INDEX (7.6 +/- 1.6 mm2/m2) than patients without obstruction (4.9 +/- 2.0 mm2/m2); P 6.6 mm2/m2 to best predict obstruction, with a sensitivity of 90% and specificity of 84%. Since Pacing is lifelong, sizing of Transvenous leads to the child is important to prevent obstruction and preserve venous access.

  • Risk factors for venous obstruction in children with Transvenous Pacing leads.
    Pacing and clinical electrophysiology : PACE, 1997
    Co-Authors: Felicia H Figa, Jeanluc Bigras, Brian W Mccrindle, Robert M Hamilton, Robert M Gow
    Abstract:

    To determine the incidence and risk factors for venous obstruction in children with Transvenous Pacing leads, 63 children were evaluated clinically and echocardiographically. Patients with abnormal clinical and/or echocardiographic findings were further investigated by venography. Thirteen patients (21%) had evidence of venous obstruction. Venography in 11 (2 refused) showed that severity of obstruction (as defined by percentage of luminal narrowing) was complete (100%) in 3, severe (> 90%) in 4, and moderate (60%-90%) in 5 (1 patient having 2 sites of obstruction). Risk factors for obstruction in 55 patients with single implantation procedures (10 with obstruction; 18%) were sought. Total cross-sectional area of lead(s) was indexed to body surface area at implantation (INDEX). Patients with obstruction had a higher mean INDEX (7.6 +/- 1.6 mm2/m2) than patients without obstruction (4.9 +/- 2.0 mm2/m2); P < 0.0002). Receiver-operator characteristic curves showed an INDEX > 6.6 mm2/m2 to best predict obstruction, with a sensitivity of 90% and specificity of 84%. Since Pacing is lifelong, sizing of Transvenous leads to the child is important to prevent obstruction and preserve venous access.

  • 904 48 risk factors for venous obstruction in children with Transvenous Pacing leads
    Journal of the American College of Cardiology, 1995
    Co-Authors: Felicia H Figa, Jeanluc Bigras, Brian W Mccrindle, Christine Boutin, Robert M Hamilton, Robert M Gow
    Abstract:

    To determine the incidence and risk factors for venous obstruction (OBST). we prospectively evaluated with echocardiography 63 of 70 eligible children who had Transvenous Pacing leads placed betwee...

  • 904-48 Risk Factors for Venous Obstruction in Children with Transvenous Pacing Leads
    Journal of the American College of Cardiology, 1995
    Co-Authors: Felicia H Figa, Jeanluc Bigras, Brian W Mccrindle, Christine Boutin, Robert M Hamilton, Robert M Gow
    Abstract:

    To determine the incidence and risk factors for venous obstruction (OBST). we prospectively evaluated with echocardiography 63 of 70 eligible children who had Transvenous Pacing leads placed between 1985 and 1993. The median (range) age at initial implantation was 7.6 yrs (0.7, 16), and 8 patients had subsequent additional implants. OBST was defined as a combination of Doppler flow abnormalities in the SVC or innominate (InnV) vein and a 2D echo appearance of vessel narrowing and/or the clinical appearance of dilated superficial veins. OBST was noted in 13/63 (21%) patients, with location of OBST at the distal subclavian vein in 5, SVC in 4, InnV-SVC junction in 2, and multiple sites in 2. Venography in 11 of these patients (2 refused) showed that the severity of OBST (as defined by % luminal narrowing) was complete (100%) in 3 patients, severe (g90%) in 4, and moderate (60–90%) in 4. Of the 8 patients who had additional implants, 3 (38%) had OBST. Risk factors for OBST in the remaining 55 single implant patients (10 with OBST; 18%) were explored. Patients with vs. without OBST did not differ regarding date or duration of implant, number of leads, lead material or the presence of associated heart defects Or surgery. Patients with OBST were younger at implant (median 5.6 vs. 8.8 yrs; p l 0.05). Total cross-sectional area of lead(s) was related to body surface area at implant (RATIO). Patients with OBST had higher mean RATIO (7.6 ± 1.6 mm 2 /m 2 ) than patients without OBST (4.9 ± 2.0 mm 2 /m 2 ; p l 0.0002). After controlling for RATIO in multiple logistic regression, no other variable predicted OBST. Receiver-operator characteristic curves showed a RATIO of g6.6 mm 2 /m 2 to best predict OBST, with a sensitivity of 90% and specificity of 84%. Conclusion Since Pacing is lifelong, sizing of Transvenous leads to the child is important to prevent OBST and preserve venous access.

Richard Shlofmitz - One of the best experts on this subject based on the ideXlab platform.

Felicia H Figa - One of the best experts on this subject based on the ideXlab platform.

  • Risk Factors for Venous Obstruction in Children with Transvenous Pacing Leads
    Pacing and Clinical Electrophysiology, 1997
    Co-Authors: Felicia H Figa, Jeanluc Bigras, Brian W Mccrindle, Robert M Hamilton, Robert M Gow
    Abstract:

    To determine the incidence and risk factors for venous obstruction in children with Transvenous Pacing leads, 63 children were evaluated clinically and echocardiographically. Patients with abnormal clinical and/or echocardiographic findings were further investigated by venography. Thirteen patients (21%) had evidence of venous obstruction. Venography in 11 (2 refused) showed that severity of obstruction (as defined by percentage of luminal narrowing) was complete (100%) in 3, severe (> 90%) in 4, and moderate (60%-90%) in 5 (1 patient having 2 sites of obstruction). Risk factors for obstruction in 55 patients with single implantation procedures (10 with obstruction; 18%) were sought. Total cross-sectional area of lead(s) was indexed to body surface area at implantation (INDEX). Patients with obstruction had a higher mean INDEX (7.6 +/- 1.6 mm2/m2) than patients without obstruction (4.9 +/- 2.0 mm2/m2); P 6.6 mm2/m2 to best predict obstruction, with a sensitivity of 90% and specificity of 84%. Since Pacing is lifelong, sizing of Transvenous leads to the child is important to prevent obstruction and preserve venous access.

  • Risk factors for venous obstruction in children with Transvenous Pacing leads.
    Pacing and clinical electrophysiology : PACE, 1997
    Co-Authors: Felicia H Figa, Jeanluc Bigras, Brian W Mccrindle, Robert M Hamilton, Robert M Gow
    Abstract:

    To determine the incidence and risk factors for venous obstruction in children with Transvenous Pacing leads, 63 children were evaluated clinically and echocardiographically. Patients with abnormal clinical and/or echocardiographic findings were further investigated by venography. Thirteen patients (21%) had evidence of venous obstruction. Venography in 11 (2 refused) showed that severity of obstruction (as defined by percentage of luminal narrowing) was complete (100%) in 3, severe (> 90%) in 4, and moderate (60%-90%) in 5 (1 patient having 2 sites of obstruction). Risk factors for obstruction in 55 patients with single implantation procedures (10 with obstruction; 18%) were sought. Total cross-sectional area of lead(s) was indexed to body surface area at implantation (INDEX). Patients with obstruction had a higher mean INDEX (7.6 +/- 1.6 mm2/m2) than patients without obstruction (4.9 +/- 2.0 mm2/m2); P < 0.0002). Receiver-operator characteristic curves showed an INDEX > 6.6 mm2/m2 to best predict obstruction, with a sensitivity of 90% and specificity of 84%. Since Pacing is lifelong, sizing of Transvenous leads to the child is important to prevent obstruction and preserve venous access.

  • 904 48 risk factors for venous obstruction in children with Transvenous Pacing leads
    Journal of the American College of Cardiology, 1995
    Co-Authors: Felicia H Figa, Jeanluc Bigras, Brian W Mccrindle, Christine Boutin, Robert M Hamilton, Robert M Gow
    Abstract:

    To determine the incidence and risk factors for venous obstruction (OBST). we prospectively evaluated with echocardiography 63 of 70 eligible children who had Transvenous Pacing leads placed betwee...

  • 904-48 Risk Factors for Venous Obstruction in Children with Transvenous Pacing Leads
    Journal of the American College of Cardiology, 1995
    Co-Authors: Felicia H Figa, Jeanluc Bigras, Brian W Mccrindle, Christine Boutin, Robert M Hamilton, Robert M Gow
    Abstract:

    To determine the incidence and risk factors for venous obstruction (OBST). we prospectively evaluated with echocardiography 63 of 70 eligible children who had Transvenous Pacing leads placed between 1985 and 1993. The median (range) age at initial implantation was 7.6 yrs (0.7, 16), and 8 patients had subsequent additional implants. OBST was defined as a combination of Doppler flow abnormalities in the SVC or innominate (InnV) vein and a 2D echo appearance of vessel narrowing and/or the clinical appearance of dilated superficial veins. OBST was noted in 13/63 (21%) patients, with location of OBST at the distal subclavian vein in 5, SVC in 4, InnV-SVC junction in 2, and multiple sites in 2. Venography in 11 of these patients (2 refused) showed that the severity of OBST (as defined by % luminal narrowing) was complete (100%) in 3 patients, severe (g90%) in 4, and moderate (60–90%) in 4. Of the 8 patients who had additional implants, 3 (38%) had OBST. Risk factors for OBST in the remaining 55 single implant patients (10 with OBST; 18%) were explored. Patients with vs. without OBST did not differ regarding date or duration of implant, number of leads, lead material or the presence of associated heart defects Or surgery. Patients with OBST were younger at implant (median 5.6 vs. 8.8 yrs; p l 0.05). Total cross-sectional area of lead(s) was related to body surface area at implant (RATIO). Patients with OBST had higher mean RATIO (7.6 ± 1.6 mm 2 /m 2 ) than patients without OBST (4.9 ± 2.0 mm 2 /m 2 ; p l 0.0002). After controlling for RATIO in multiple logistic regression, no other variable predicted OBST. Receiver-operator characteristic curves showed a RATIO of g6.6 mm 2 /m 2 to best predict OBST, with a sensitivity of 90% and specificity of 84%. Conclusion Since Pacing is lifelong, sizing of Transvenous leads to the child is important to prevent OBST and preserve venous access.

Srinath T. Gowda - One of the best experts on this subject based on the ideXlab platform.

  • Usefulness of vascular stenting with and without Transvenous Pacing leads for vena caval obstruction among children and adults with repaired congenital heart disease.
    The American journal of cardiology, 2015
    Co-Authors: Daisuke Kobayashi, Thomas J. Forbes, Daniel R. Turner, Harinder R. Singh, Peter P. Karpawich, Srinath T. Gowda
    Abstract:

    Vena caval obstruction (VCO) is a common complication after vascular manipulation for congenital heart disease. Long-term efficacy of stent therapy for relief of VCO and long-term stent patency with and without intrastent Transvenous Pacing leads (TPLs) is not well described. This was a retrospective review of patients treated for VCO, including those who received intrastent TPLs, between 1995 and 2012. Patient demographics, diagnoses, vascular pressure gradients, and vessel diameters were analyzed. Forty-one patients (mean age 23.5 ± 10.3 years) with and without congenital heart disease underwent stent implantation, 26 of whom also received intrastent TPLs. Short-term stent implantation success in relieving obstructions was 93%. Poststent vascular pressure gradients and percentage vascular narrowing significantly improved (from 6.2 ± 4.5 to 1.1 ± 1.6 mm Hg and from 63.1 ± 19.5% to 18.0 ± 17.1%, respectively, p

  • Transvenous Pacing Leads for Vena Caval Obstruction Among Children and Adults With Repaired Congenital Heart Disease
    2015
    Co-Authors: Daisuke Kobayashi, Thomas J. Forbes, Daniel R. Turner, Harinder R. Singh, Peter P. Karpawich, Srinath T. Gowda
    Abstract:

    Vena caval obstruction (VCO) is a common complication after vascular manipulation for congenital heart disease. Long-term efficacy of stent therapy for relief of VCO and longterm stent patency with and without intrastent Transvenous Pacing leads (TPLs) is not well described. This was a retrospective review of patients treated for VCO, including those who received intrastent TPLs, between 1995 and 2012. Patient demographics, diagnoses, vascular pressure gradients, and vessel diameters were analyzed. Forty-one patients (mean age 23.5 – 10.3 years) with and without congenital heart disease underwent stent implantation, 26 of whom also received intrastent TPLs. Short-term stent implantation success in relieving obstructions was 93%. Poststent vascular pressure gradients and percentage vascular narrowing significantly improved (from 6.2 – 4.5 to 1.1 – 1.6 mm Hg and from 63.1 – 19.5% to 18.0 – 17.1%, respectively, p

Rowarth A.j. Spurrell - One of the best experts on this subject based on the ideXlab platform.

  • Transvenous Pacing lead-induced thrombosis: a series of cases with a review of the literature.
    Cardiology, 2000
    Co-Authors: Khalid Barakat, Nicholas M. Robinson, Rowarth A.j. Spurrell
    Abstract:

    Although Transvenous Pacing is a safe treatment modality for bradyarrhythmias, serious thrombotic and embolic complications are reported to occur in 0.6-3.5% of cases. We describe 5 cases of pacemaker-associated thrombosis, 3 with a superior vena cava syndrome (SVC), 1 with an axillary vein thrombosis and 1 with a thrombus attached to the Pacing lead in the right atrium. All of the patients were initially treated with intravenous heparin which proved successful as the sole treatment in only the least severe case (axillary vein thrombosis). One of the patients with SVC obstruction was successfully treated with intravenous heparin followed by thrombolytic therapy. The remaining 3 cases (2 SVC syndromes and 1 right atrial thrombus) required surgical removal of thrombus and Pacing leads. Both of the patients with evidence of infection were in the group for whom failure of medical therapy necessitated surgery.

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