AIM   AIM To investigate the occurance of venous thrombosis after intravenous pacemaker implantation and potential factors to avoid late vein occlusion or bringing difficulties in pacemaker upgrading or lead revision.

  METHODS   The present investigation included 84 patients who returned to clinic and had rechecked vascular ultrasound of ipsilateral subclavian, axillary, and internal jugular veins during 2017. Preoperative information of clinical data, laboratory tests, echocardiography, and vascular ultrasounds of bilateral subclavian, axillary, and internal jugular veins, utilization of anti-platelet and/or anticoagulant drugs, analysis of incidence of venous thrombosis after pacemaker procedure and possible risk factors were measured.

  RESULTS   3 patients (4%) developed venous thrombosis after the procedure. These patients had a dilated cardiomyopathy (DCM) with severe heart function and paroxysmal atrial fibrillation (PAF), single pacemaker upgraded to dual pacemaker, and the third case, congenital Ebstein anomaly with Ⅲ°AVB, lead perforation the second day after the pacemaker implantation and received another new RV lead re-implantation with removal of the perforated one.

  CONCLUSION   There was a relatively low risk of venous thrombosis after pacemaker implantation, mainly in those patients with complicated implantation procedures, severe heart dysfunction, (heart) morphological abnormality, and serious complications such as lead perforation.