Clinical characteristics of patients with indication of cardiac implantable electronic devices implantation complicating with acute pulmonary thromboembolism.
10.3760/cma.j.cn112148-20200513-00393
- VernacularTitle:心脏置入型电子器械适应证患者合并急性肺血栓栓塞的临床特征初探
- Author:
Xiao Hui NING
1
;
Wen Tao MA
1
;
Xiao Han FAN
1
;
Xiao Fei LI
1
;
Qian WANG
1
;
Zhi Min LIU
1
;
Shu ZHANG
1
Author Information
1. Center of Arrhythmia, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China.
- Publication Type:Journal Article
- Keywords:
Anticoagulants;
Cardiac implantable electronic devices;
Pulmonary embolism
- MeSH:
Aged;
Aged, 80 and over;
Death, Sudden, Cardiac;
Defibrillators, Implantable;
Female;
Humans;
Male;
Pacemaker, Artificial;
Pulmonary Embolism/complications*;
Retrospective Studies
- From:
Chinese Journal of Cardiology
2020;48(10):837-841
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the clinical characteristics of inpatients with the indication of cardiac implantable electronic devices (CIED) therapy and combined acute pulmonary thromboembolism (APTE). Methods: We retrospectively screened 8 641 inpatients who admitted with the indication of CIED implantation in Fuwai Hospital from January 2014 to May 2019. The clinical characteristics, management strategies and clinical outcome were analyzed for patients diagnosed as APTE. Results: APTE were identified in 45 (5‰) patients in this cohort, there were 18(40%) male patients, the average age was (73±8) years old and body mass index was (27±10) kg/m2.Thirty-two (70%) patients were at intermediate-risk and 13 (30%) at low-risk. Anti-coagulation therapy was initiated in 38(84%) patients, and 30 patients underwent CIED implantation (27 pacemaker, 2 CRT and 1 ICD). No postoperative bleeding or pocket hematoma were detected in the 23 patients taking anticoagulation medication before implantation. During an average of (30±7) months' follow up, thrombus was dissolved in 20 patients, hemorrhage complications were observed in 2 patients (1 cerebral hemorrhage and 1 hematuria), anticoagulation therapy was discontinued in these 2 patients. Among 15 patients without immediate CIED implantation and treated with anticoagulation therapy during hospitalization, 2 patients developed complete paroxysmal Ⅲ° atrioventricular block, and recovered after therapy during hospitalization. Seven patients were re-hospitalized for CIED implantation due to bradycardia. Five patients died during follow-up (3 sudden cardiac death, 1 APTE combined with cerebral infarction, and 1 pulmonary infection). Conclusion: APTE is not rare in patients with the indication of CIED implantation, CIED implantation and anti-coagulation therapy are safe for these patients, and transient atrioventricular block could be detected in APTE patients.
