Upper Limb Deep Vein Thrombosis Following Pacemaker Insertion: A Report of Two Cases

Upper limb deep vein thrombosis (DVT) has become a more common condition due to the growing use of cardiac device implantation. We report two cases of left upper limb DVT occurring five days and three months, respectively, after permanent pacemaker implantation. Both patients presented with progressive swelling of the left upper limb associated with dilated superficial veins across the left chest and upper arm. Ultrasound (US) compression venography confirmed occlusive thrombi in the left axillary and subclavian veins. They received direct oral anticoagulant (DOAC) therapy after the diagnosis. This case series highlights the variable timing of symptom onset following permanent pacemaker insertion and emphasises the other risk factors, such as essential thrombocythaemia, to the development of upper limb DVT.