Incidence and predictors of subclavian vein obstruction following biventricular device implantation

The data about the incidence of subclavian venous (SCV) obstruction or thrombosis after biventricular device implantation is limited. Therefore, we aimed to assess the incidence and predictors of venous obstruction after biventricular device implantation with or without a defibrillator in patients with left ventricular systolic dysfunction and cardiac dyssynchrony.

Eighty-six patients who had undergone biventricular device implantation were included in the study. Subclavian vein was patent in 61% of all participants. Among the patients with subclavian obstruction (n = 33), 8 had mild obstruction, 15 had severe obstruction, and 10 had total occlusion. The presence of additional implantable cardioverter defibrillator (ICD) and the number of leads that were used were found to be significant covariates of obstruction in subclavian vein after biventricular device implantation (p = 0.004 and p = 0.01, respectively). Atrial fibrillation after biventricular pacemaker and ICD implantation was significantly related with total occlusion (r = 0.3, p = 0.005 and r = 0.24, p = 0.003, respectively).

Patients who are candidates for biventricular device implantation are at increased risk for venous obstruction when compared with other pacemaker patients and this causes higher incidence of venous obstruction among these patients.