Effects of permanent cardiac pacemaker implantation on vascular endothelial function, blood coagulation and cardiac function in patients with bradycardia

Abstract

Changes in vascular endothelial function, blood coagulation and cardiac function indexes after the implantation of a permanent cardiac pacemaker in patients with bradycardia were investigated. A total of 53 healthy people and 117 patients with bradycardia in Jining First People's Hospital from January 2015 to August 2017 were selected. Factor VIII: coagulation (FVIII:C), von Willebr and factor (vWF), antithrombin activity (AT:A), D-dimmer (D-D), thrombomodulin (TM), tissue factor (TF), left ventricular ejection fraction (LVEF) and left ventricular end-systolic volume (LVESV) in the non-pacemaker group and the pacemaker group were significantly different from those in the control group (P<0.05), in which FVIII:C, vWF, D-D, TM, TF and LVESV were significantly higher than those in the control group, while LVEFs were significantly lower than that in the control group. After the implantation of a pacemaker, the FVIII:C, vWF, fibrinogen (FIB), D-D, TF and LVESV in patients were significantly higher than those before implantation (P<0.05), while the LVEF was significantly lower than that before implantation (P<0.05). In addition, in different pacemaker groups, there were no significant differences in blood coagulation and vascular endothelial indexes, but differences in cardiac function levels were obvious, in which LVEF in dual-chamber (DDD) pacemaker group was significantly higher than that in ventricular inhibited (VVI) pacemaker group, and LVESV in the former was significantly lower than that in the latter (P<0.05). Finally, here was no significant difference in the quality of life of patients implanted with different pacemakers (P>0.05), but the quality of life of patients in the DDD pacemaker group was better than that of patients in the VVI group. Therefore, implanting pacemakers in patients with bradycardia affects vascular endothelial function, blood coagulation, and cardiac function indexes in patients, and complications become less after the implantation of DDD pacemakers.

Perioperative coagulation activation after permanent pacemaker placement

“…Conditions are produced at the damaged area to enable the hemostasis system to function. A rise in tissue factor and von Willebrand factor in patients following pacemaker implantation supports this idea[ 3 , 9 , 11 ]. The second place of activation of the hemostasis system is the area of contact of the lead with endocardium.…”

“…Many studies on the topic of coagulation in PM patients have been published in the international literature. The majority of these studies focus on how these patients' coagulation patterns relate to deep vein thrombosis (DVT) of the upper extremities and venous thromboembolism in general[ 3 , 11 , 14 , 16 , 17 ]. Zhang et al [ 3 ] noted an increase in FVIII activity 7 d after surgery.…”

“…The majority of these studies focus on how these patients' coagulation patterns relate to deep vein thrombosis (DVT) of the upper extremities and venous thromboembolism in general[ 3 , 11 , 14 , 16 , 17 ]. Zhang et al [ 3 ] noted an increase in FVIII activity 7 d after surgery. Lelakowski et al [ 11 ] observed an increase in FVII activity at the same period.…”

“…Bradyarrhythmias are typically treated with permanent PM. The elimination of bradyarrhythmia by PM implantation improves the patient's quality of life and prognosis, but it can also result in a number of sequalae[ 1 , 3 , 4 ]. It is still unclear how PM implantation affects the hemostasis system's parameters and how those parameters relate to different problems and other consequences.…”

Changes of endothelial function and intracardiac hemodynamics during implantation of different types of pacemakers

“…Так, однокамерная стимуляция с фиксацией желудочкового электрода в области ВПЖ приводит к увеличению размеров сердца в систолу и диастолу, снижению ФВ по сравнению с двухкамерной. Имеет значение и расположение электрода в ПЖ, при котором апикальная стимуляция приводит к более выраженным изменениям функции сердца [10,11]. В то же время есть ряд работ, в которых желудочковая стимуляция не повлияла на внутрисердечную гемодинамику левых отделов сердца [12,13].…”