Effect of anticoagulation on the occurrence of deep venous thrombosis associated with temporary transvenous femoral pacemakers

Abstract

Temporary cardiac pacing is an established, often life-saving therapy for medically refractory bradyarrhythmias and certain tachyarrhythmias. Transvenous endocardial pacing is a simple, safe, and effective means of temporary pacing. The transfemoral route is frequently utilized due to its technical simplicity and perceived low incidence of complications.1,2 However, previous small studies have described an incidence of asymptomatic deep venous thrombosis (DVT) in the lower limbs of 25% to 34% in association with transfemoral pacing.3–5 Despite the potential for DVT in these early reports, no consensus exists for the antithrombotic management of patients with temporary transvenous femoral pacemakers. In particular, the efficacy and risks of therapeutic anticoagulation (with heparin) for the prevention of DVT in these patients has not been evaluated. In this prospectively designed study, we determined the incidence of lower limb DVT associated with temporary transvenous femoral pacemakers by duplex ultrasonography, and importantly, evaluated the efficacy and safety of differing heparin regimes in preventing DVT.