The utility of a CHA 2 DS 2 -VASc score in predicting the presence of significant stenosis and occlusion of veins with indwelling endocardial leads

Boczar, Krzysztof; Ząbek, Andrzej; Dębski, Maciej; Haberka, Kazimierz; Rydlewska, Anna; Lelakowski, Jacek; Małecka, Barbara

doi:10.1016/j.ijcard.2016.05.025

Cited by 3 publications

(2 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Contrary to the previous report [ 30 ], the present study did not demonstrate the protective role of the CHA2DS2-VASc score in preventing LRVSO. Multivariate analysis in our study showed that a 1-point difference in the CHA2DS2-VASc score increased the likelihood of severe stenosis or lead-related venous obstruction by 7.8%.…”

Section: Discussioncontrasting

confidence: 99%

Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction

Czajkowski

Jacheć

Polewczyk

et al. 2021

JCM

View full text Add to dashboard Cite

Background: our knowledge of lead-related venous stenosis/occlusion (LRVSO) remains limited and there is still controversy regarding the risk factors for LRVSO. Venography is mandatory before transvenous lead extraction (TLE). Methods: we performed a retrospective analysis of venograms in 2909 patients (39.43% females, average age 66.90 years) who underwent TLE between 2008 and 2021 at high-volume centers. Results: the severity of LRVSO was likely to be dependent on the number of leads in the system (OR = 1.345; p = 0.003), the number of abandoned leads (OR = 1.965; p < 0.001), the presence of coronary sinus leads (OR = 1.184; p = 0.056), male gender (OR = 1.349; p = 0.003) and patient age at first CIED implantation (OR = 1.008; p = 0.021). The presence of permanent atrial fibrillation (OR = 0.666; p < 0.001) and right ventricular diastolic diameter (OR = 0.978; p = 0.006) showed an inverse correlation with the degree of LRVSO. The combined three-model multivariate analysis provided better prediction of LRSVO using the above-mentioned factors than the CHA2DS2-VASc score. Conclusions: the severity of LRVSO is probably dependent on the mechanical impact of the implanted/abandoned leads on the vein wall, therefore the study has demonstrated the central role of system-/procedure-related risk factors. The thrombotic mechanism may be less important, especially long after implantation, and for this reason the combined prediction model for LRVSO in this study was more effective than the CHA2DS2-VASc score.

show abstract

Section: Discussioncontrasting

confidence: 99%

Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction

Czajkowski

Jacheć

Polewczyk

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…Chronic renal disease seems to additionally promote calcium incorporation in TFLEs (26). Factors associated with arterial calcification such as uremia and diabetes mellitus (49) have been suggested to likewise predispose veins for mineralization (25) while diabetes in turn was suggested to be a predictive factor for a lower risk for lead-related venous stenosis and occlusion (50).…”

Section: Tfle Calcificationsmentioning

confidence: 99%

Quantitative and Qualitative Assessment of Adhesive Thrombo-Fibrotic Lead Encapsulations (TFLE) of Pacemaker and ICD Leads in Arrhythmia Patients—A Post Mortem Study

Keiler

Schulze

Dreger

et al. 2020

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

The demand for cardiac implantable electronic devices for arrhythmia therapy is still unabated and rising. Despite onward optimizations, lead-related problems such as infections or fractures often necessitate lead extraction. Due to adhesive thrombo-fibrotic lead encapsulations (TFLE) transvenous lead extraction is challenging and risky. However, knowledge on TFLEs and possible correlations with technical lead parameters and dwelling time (DT) were hitherto insufficiently studied. Therefore, we analyzed TFLEs of 62 lead from 35 body donor corpses to gain information for a potential lead design optimization. We examined both TFLE topography on the basis on anatomical landmarks and histo-morphological TFLE characteristics by means of histological paraffin sections and scanning electron microscopy of decellularized samples. The macroscopic analysis revealed that all leads were affected by TFLEs, mainly in the lead bearing veins. Half (47.2%) of the right-ventricular leads possessed adhesions to the tricuspid valve. On average, 49.9 ± 21.8% of the intravascular lead length was covered by TFLE of which 82.8 ± 16.2% were adhesive wall bindings (WB). The discrete TFLEs with at least one WB portion had a mean length of 95.0 ± 64.3 mm and a maximum of 200 mm. Neither sex, DT nor certain technical lead parameters showed distinct tendencies to promote or prevent TFLE. TFLE formation seems to start early in the first 1–2 weeks after implantation. The degree of fibrotization of the TFLE, starting with a thrombus, was reflected by the amount of compacted collagenous fibers and likewise largely independent from DT. TFLE thickness often reached several hundred micrometers. Calcifications were occasionally seen and appeared irregularly along the TFLE sheath. Leadless pacemaker systems have the advantage to overcome the problem with TFLEs but hold their own specific risks and limitations which are not fully known yet.

show abstract

Does CHA2DS2-VASc score have the discrimination and calibration power in predicting renal function decline?

Chen

Cai

Zha

et al. 2018

International Journal of Cardiology

View full text Add to dashboard Cite

The utility of a CHA 2 DS 2 -VASc score in predicting the presence of significant stenosis and occlusion of veins with indwelling endocardial leads

Cited by 3 publications

References 23 publications

Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction

Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction

Quantitative and Qualitative Assessment of Adhesive Thrombo-Fibrotic Lead Encapsulations (TFLE) of Pacemaker and ICD Leads in Arrhythmia Patients—A Post Mortem Study

Does CHA2DS2-VASc score have the discrimination and calibration power in predicting renal function decline?

Contact Info

Product

Resources

About