RESUMEN
BACKGROUND: Venous stenosis and occlusion in the presence of endocardial leads constitute one of the complications of permanent cardiac pacing either by pacemaker, implantable cardioverter-defibrillator or cardiac resynchronization therapy. OBJECTIVES: The aim of this study was to assess the incidence of stenosis and occlusions and determine the risk factors in patients with endocardial leads in a prospective single-center study. MATERIAL AND METHODS: Two hundred eighty consecutive patients aged 25-95 years (male 68.8%) were included. A contrast venography examination of the ipsilateral access vein was performed. The whole study population was divided into 2 groups, based on the presence (group I) or absence (group II) of endocardial leads. RESULTS: Venous stenosis/occlusion was identified in 51 patients (37.5%) in group I and in 3 patients (3.6%) in group II; p < 0.0001. The lead presence most highly correlated with venous complications (OR = 4.172; p < 0.001). In patients with endocardial leads divided into I A and I B according to venous patency diabetes mellitus was proved in multivariate analysis to be the only protective factor against the development of venous stenosis/occlusion (OR = 0.473; p = 0.010). CONCLUSIONS: The presence of endocardial leads is a predisposing factor for venous stenosis/occlusion and increases the risk 4-fold. The venous lesions in the presence of endocardial leads are less frequent among patients with diabetes mellitus.
Asunto(s)
Cateterismo Venoso Central/efectos adversos , Cateterismo Periférico/efectos adversos , Desfibriladores Implantables/efectos adversos , Marcapaso Artificial/efectos adversos , Enfermedades Vasculares/epidemiología , Venas , Adulto , Anciano , Anciano de 80 o más Años , Dispositivos de Terapia de Resincronización Cardíaca/efectos adversos , Distribución de Chi-Cuadrado , Cineangiografía , Constricción Patológica , Diabetes Mellitus/epidemiología , Femenino , Humanos , Incidencia , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Flebografía/métodos , Polonia/epidemiología , Estudios Prospectivos , Diseño de Prótesis , Factores Protectores , Medición de Riesgo , Factores de Riesgo , Enfermedades Vasculares/diagnóstico por imagen , Enfermedades Vasculares/fisiopatología , Grado de Desobstrucción Vascular , Venas/fisiopatologíaAsunto(s)
Electrodos Implantados/efectos adversos , Marcapaso Artificial/efectos adversos , Insuficiencia de la Válvula Tricúspide/etiología , Insuficiencia de la Válvula Tricúspide/fisiopatología , Válvula Tricúspide/fisiopatología , Humanos , Masculino , Válvula Tricúspide/diagnóstico por imagen , Ultrasonografía , Adulto JovenRESUMEN
Electrocardiography is a method which can not be replaced by any other examination in arrhythmias. It also plays a crucial role in the diagnosis of arrhythmic rare diseases by providing not only diagnostic data, but also paving the way for treatment. This article presents some characteristic examples of ECG in arrhythmic rare diseases (i.e., polimorphic ventricular tachycardia, Brugada syndrome, Coumela syndrome, nonreentrant supraventricular tachycardia with double ventricular response).