Subacute Deep Venous Thrombosis After CRT Device Implantation

Cardiac resynchronization therapy (CRT), is regarded as an effective therapy for patients with chronic heart failure. CRT involves stimulus on both right and left ventricles, which may induce contraction synchronously on both ventricles. By correcting interventricular conduction delay and reversing cardiac remodeling, CRT can significantly increase left ventricular ejection fraction, improve quality of life and exercise tolerance and lower mortality. Based on the traditional pacemaker implantation, LV pacing was needed in the CRT.by placing the LV lead via the coronary sinus. The complex procedure leads to more complications than the dual chamber pacemakers implantation. Currently, left ventricular electrode dislocation, phrenic nerve stimulation and pocket hematoma are the most common complications in clinical application. Nevertheless, acute upper extremity deep venous thrombosis caused by CRT is rarely reported. Here we report a case of deep venous thrombosis after CRT device implantation in a patient with Dilated Cardiomyopathy. A 61-year-old male patient with left upper limb swelling as the main manifestation, was diagnosed with left subclavian and internal jugular and innominate vein thrombosis by ultrasonography. The subject was treated with urokinase and low molecular weight heparin for 7days followed by long term oral anticoagulation therapy with warfarin.6 months later, the thrombus disappeared and the venous flow recovered to a normal level. The patient was advised to adhere to taking warfarin and follow-up.