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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Risk factors and prognosis for clot formation on cardiac device leads
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Risk factors and prognosis for clot formation on cardiac device leads

机译：心脏设备导线上血块形成的危险因素和预后

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Background Clot formation on cardiac device leads is poorly understood. We sought to determine how often clot is seen on device leads by transthoracic echo (TTE), identify risk factors, and to describe the natural history of this phenomenon. Methods We reviewed 71,888 echocardiographic studies performed at the University of California, San Francisco from 2005 to 2011. We searched for cases where clot was found adhered to a device lead with no diagnosis of endocarditis. For every case, three age-matched controls with a device but no clot were selected from the echo database. Results We found 15 cases with clot adhered to a device lead among 1,086 patients with devices who had TTE (1.4%). In univariate analysis, females had more than four times greater odds of having a clot on their device lead and patients with a history of atrial fibrillation (AF) had an eight times greater odds. Percentage mode switch was also associated with clot formation. Only AF was still associated with clot formation after multivariate analysis. Follow-up data were available for nine of 15 patients. All nine patients had intensification of their anticoagulant/antiplatelet regimen following clot discovery. Complete resolution or shrinkage of clot was observed in eight of nine patients. The one case with no change was a patient who continued taking only aspirin (higher dose) after clot discovery. None of the nine patients had embolic phenomenon. Conclusion Patients with AF are at higher risk for clot formation on device leads. After clot detection, treatment with anticoagulants usually results in resolution of the clot without embolic phenomenon.
机译：背景对心脏设备导线上的血栓形成了解甚少。我们试图确定经胸腔回声（TTE）在设备导线上见到凝块的频率，确定危险因素，并描述这种现象的自然历史。方法我们回顾了2005年至2011年在加利福尼亚大学旧金山分校进行的71,888例超声心动图研究。我们搜索了发现凝块附着在未诊断出心内膜炎的设备导线上的病例。对于每种情况，从回波数据库中选择了三个具有设备但没有血块的年龄匹配的控件。结果我们在1,086例患有TTE的器械患者中发现了15例凝结在器械导线上的血凝块（1.4％）。在单变量分析中，女性在设备导线上形成凝块的几率高出四倍，而有心房颤动（AF）病史的患者则有八倍的几率。百分比模式切换也与血块形成有关。多变量分析后，仅AF仍与血凝块形成相关。 15位患者中有9位获得了随访数据。发现血块后，所有九名患者的抗凝/抗血小板方案均已加强。 9名患者中有8名观察到血块完全消退或缩小。一例无变化的患者是发现血块后仅继续服用阿司匹林（较高剂量）的患者。 9例患者均无栓塞现象。结论AF患者在设备导线上形成血块的风险较高。凝块检测后，用抗凝剂治疗通常可消除血栓而无栓塞现象。

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