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There are no evidence based studies dealing with the incidence of venous sheath related thrombosis and the role of heparin, particularly in the setting of prolonged procedures with multiple lines. The clinical importance of catheter related thrombosis remains undefined in the setting of electrophysiological studies (EPS). We sought to determine the incidence of multiple venous sheath related thrombosis and the role of fixed dose, body weight independent, low molecular weight heparin (LMWH) for prophylaxis of venous thrombosis in patients undergoing EPS.
We examined 27 consecutive patients undergoing EPS. Institutional approval and informed consent were obtained. Patients were randomised into two groups according to use of LMWH (fixed dose subcutaneous injection of dalteparin 5000 units). Dalteparin was injected one hour before insertion of sheaths. All catheters (Cordis Inc, Miami, USA) were inserted using the Seldinger technique in the same side of the femoral vein. The size of the catheter sheaths ranged from 6–8 French. At catheter insertion the following parameters were recorded: patient age and catheter duration, number, position, type, and size. Investigation and diagnosis of venous thrombosis was made by ultrasound examination. After EPS was completed, the catheters were immediately removed and firm pressure was applied by hand to the femoral vein area for 15–20 minutes. Follow up ultrasound examination was performed at …