Changes in Coagulation Parameters After Permanent Pacemaker Implantation

I.D. Yoncheva 1 , D.E. Biserov 1 , and M.N. Negreva 2
  • 1 University Hospital Virgin Mary, , Burgas, Bulgaria
  • 2 University Hospital St. Marina, , Varna, Bulgaria

Abstract

The connection between venous thrombotic events in patients with implanted pacemakers and changes in coagulation factors has been the basis of numerous scientific studies for years. Results show that the effect on the coagulation system is a long-term and dynamic process, as well as presence of a significant dependence with many concomitant cardiovascular diseases.

Advances in medicine in recent decades and increase in life expectancy of patients with implanted cardiac devices (ICD) increase the risk of a variety of complications. These adverse events may be associated with development of thrombosis, change in the stimulation threshold, need for ablation due to concomitant rhythm pathology and others. Analysis of data from literature shows unequivocally that placement of endocardial electrodes leads to activation of the coagulation system in the body. On the one hand, this is a result of the direct traumatic moment and endothelial damage in the early post-procedure period, and subsequently, the presence of electrodes of the foreign body type in some individuals can provoke a procoagulation state.

More in-depth research is needed in this area to clarify the answers to these questions, namely: in which phase of the coagulation cascade are the changes most significant; is there a way to anticipate these changes and prevent them accordingly; is disturbed homeostasis of coagulation temporary or persistent.

These questions will be answered after sufficient data have been accumulated on these changes and how to modulate them.

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