• Juan J García Guerrero, Joaquín Fernández de la Concha Castañeda, Domingo López Quero, Gabriel Collado Bueno, José R Infante de la Torre, Juan I Rayo Madrid, and Angel Redondo Méndez.
• Department of Cardiology, Hospital Infanta Cristina, Ctra. Portugal S/N, Badajoz 06080, Spain. juanjose.garcia@ya.com
• Europace. 2010 Nov 1;12(11):1604-7.

AimsTemporary transfemoral cardiac pacing is widely accepted, but is associated with high incidence of asymptomatic deep vein thrombosis (DVT), which in turn is associated with restricted patient mobility. The passive-fixation lead typically used in this procedure restricts patient mobility during implantation.Methods And ResultsAn active-fixation lead allowing normal ambulation was prospectively assessed in 47 consecutive patients. Prior to explantation, venous duplex ultrasound was performed to determine DVT incidence, with the contralateral leg as control. To reduce possible false negatives, ventilation/perfusion scintigraphy was also performed (n = 42). Patient mobility during implantation was classified as high (n = 29), moderate (n = 6), or low (n = 12). Anticoagulants were limited to cases meeting standard guidelines. Asymptomatic DVT was diagnosed in three patients (6.4%), compared with 25-39% reported using standard passive-fixation leads. Furthermore, all of these patients had low mobility during the implantation period. No post-implantation lung scan showed high probability of pulmonary embolism.ConclusionIn the 75% of patients with moderate or high mobility, there were no DVT cases. The 6.4% DVT incidence was limited to patients with low mobility and was significantly lower than the norm for this procedure. A larger, randomized study is needed to confirm the benefits of the mobility allowed by an active-fixation lead.

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