Prevention of Deep Vein Thrombosis Associated with Temporary Transvenous Cardiac Pacemakers by Enoxaparin

Background: the purpose of this prospective study is to quantify the risk of lower limb deep venous thrombosis(dvt) in patients requiring temporary transvenous femoral pacing and to evaluate the use of different enoxaparindosages (prophylactic or therapeutic) for thrombus prevention. transvenous temporary cardiac pacemaker,with catheters frequently used along the femoral vein is useful to relieve difficult bradyarrythmias and sometachyarrythmias. up to one-third of patients receiving transfemoral pacing develop asymptomatic dvt. atpresent, there are no recommendations for thrombus prophylaxis in these patients. besides, the efficacy in thisspecific condition has not been studied.methods: sixty consecutive patients who underwent transvenous femoral pacing and had no contraindicationto low molecular weight heparin (lmwh) therapy were divided into 3 groups each group consisted of 20 patients.group i received prophylactic enoxaparin (1mg/kg/day; subcutaneously), group ii received therapeuticenoxaparin (1 mg/kg/day every 12 hours; subcutaneously), and group iii consisting of patients who were nottreated with enoxaparin was considered as control group. patients were evaluated daily for clinical features ofdvt. color doppler sonography imaging was performed on both lower limbs of all patients within 24 hoursafter removal of the temporary pacemakers.results: of the sixty patients, two who belonged to group iii, had definitive evidence of right lower limb dvtby color doppler sonography. these two cases of dvt were asymptomatic and had thrombosis of femoral vein.no evidence of thrombus was detected in contra lateral lower limb. no dvt was detected among patients whoreceived prophylactic or therapeutic doses of enoxaparin. no heparin related complications were detected inthis study. there were no significant difference in the clinical characteristics among 2 groups (i, ii) and controlgroup. correlations of age and gender with occurrence of dvt were not significant (p= 0.512, 0.737).conclusions: this study showed that dvt is a common complication of femoral pacing, and that its incidencecan be reduced with the use of prophylaxis and therapeutic intravenous enoxaparin.