no A-Fib, but still throwing clots

hello, I have familial cardiomypoathy-13 years, CHF, EF25%, and a biventricular pacemaker/ICD for V-tach.  One month ago, I had a TIA.  Two weeks later, I had a renal infarction.  Docs think these clots are coming from my heart and put me on coumadin. Since the TIA, I have bright blue veins on my left chest, arm, side,and purple on my palm.  This is all a left side phenomena.  It literally starts at midline on my chest- clear on the right and all visible veins on the left.  I had a venous doppler which was negative. One of my cardiologists mentioned superior vena cava syndrome, but the other docs don't agree.  Could I have a thrombus on one of my pacemaker leads causing all of this?  I have been on coumadin about 3 weeks- 3.8 INR today, and no change in the veins.  I know something is off.  Can you tell me what it might be and whether I should ask for further tests?  Thank you.

[Jerry_NJ]

I can't say I have any real help for your question/problem, but I can say that clots can form without accompanying AFib, that is AFib is sufficient for the formation of clots, but it is not necessary.  

What is your target INR?  I have AFib and I take warfarin (coumadin) to hold an INR between 2.0 and 3.0.  I understand people with artificial heart valves my have to maintain an INR in the next step 3.0 to 4.0, where you are.  I think this range has a high potential for bruising, could this realted to what you are experiencing?  Have you (with doctor's approval) tried to hold you INR at a lower number to see if that reduces the vein condition?  Are the veins also standing out, vericose-like?  

I hope you find out what the problem is and that you can stop clot formation.  Clots are very dangerous, as I'm sure you know.