Cardiovascular Engineering

, Volume 10, Issue 2, pp 84–90

New Insights into Pacemaker Lead-Induced Venous Occlusion: Simulation-Based Investigation of Alterations in Venous Biomechanics

  • Anna Lonyai
  • Anne M. Dubin
  • Jeffrey A. Feinstein
  • Charles A. Taylor
  • Shawn C. Shadden
Technical Note

DOI: 10.1007/s10558-010-9096-x

Cite this article as:
Lonyai, A., Dubin, A.M., Feinstein, J.A. et al. Cardiovasc Eng (2010) 10: 84. doi:10.1007/s10558-010-9096-x

Abstract

Venous obstruction is a major complication of transvenous pacemaker placement. Despite the increasing use of pacemakers and implantable cardiac defibrillators, a lack of understanding remains with regard to risk factors for the development of device-associated venous obstruction. We hypothesize that computational fluid dynamics simulations can reveal prothrombogenic locations and define thrombosis risk based on patient-specific anatomies. Using anatomic data derived from computed tomography, computer models of the superior vena cava, subclavian, innominate, and internal jugular veins were constructed for three adult patients with transvenous pacemakers. These models were used to perform patient-specific simulations examining blood flow velocity, wall shear stress, and blood pressure, both with and without the presence of the pacing leads. To better quantify stasis, mean exposure time fields were computed from the venous blood flow data. In comparing simulations with leads to those without, evident increases in stasis at locations between the leads and along the surface of the vessels closest to the leads were found. These locations correspond to regions at known risk for thrombosis. This work presents a novel application of computational methods to study blood flow changes induced by pacemaker leads and possible complications such as venous occlusion and thrombosis. This methodology may add to our understanding of the development of lead-induced thrombosis and occlusion in the clinical arena, and enable the development of new strategies to avoid such complications.

Keywords

Venous occlusion Pacemaker leads Computational fluid dynamics 

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Anna Lonyai
    • 1
  • Anne M. Dubin
    • 2
  • Jeffrey A. Feinstein
    • 2
    • 3
  • Charles A. Taylor
    • 3
  • Shawn C. Shadden
    • 4
  1. 1.School of MedicineStanford UniversityPalo AltoUSA
  2. 2.Department of Pediatrics–Division of CardiologyStanford UniversityPalo AltoUSA
  3. 3.Department of BioengineeringStanford UniversityPalo AltoUSA
  4. 4.Mechanical, Materials and Aerospace EngineeringIllinois Institute of TechnologyChicagoUSA

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