Objective To analyze the efficacy and safety of different anticoagulants on cardiovascular implantable electronic devices (CIED) lead-related venous thrombosis. Methods A total of 38 patients with CIED lead-related venous thrombosis diagnosed with postoperative vascular ultrasound examination in our department from January 2018 to December 2019 were recruited in this study. They were randomly divided into warfarin group (n=19) and dabigatran group (n=19). Digital subtraction angiography (DSA) in the implanted veins and QAngio XA software were performed in both groups before and after treatment respectively to evaluate the change of vascular stenosis. The effectiveness of anticoagulant therapy and the incidence of complications after anticoagulant therapy were observed. SPSS 21.0 was used for statistical analysis. The data were analyzed by student′s t test, t′ test, Chi-square test or the Fisher exact test. Results There was no significant difference in the efficiency rate of anticoagulant therapy between the 2 groups at 1,3 and 6 months after treatment (all P>0.05). But in 12 months after treatment, the efficiency rate was significantly higher in the dabigatran group than the warfarin group [94.74% (18/19) vs 68.42% (13/19); P<0.05]. In the warfarin group, the efficiency rate at 3,6 and 12 months was obviously higher than that at 1 month after treatment [57.89% (11/19), 68.42% (13/19) and 68.42% (13/19) vs 21.05% (4/19), all P<0.05]. The dabigatran group also got great improvement in the efficiency rate at 6 and 12 months when compared with that at 1 month [84.21% (16/19) and 94.74% (18/19) vs 26.32% (5/19), both P<0.05). There was no statistical difference in the incidence of complications between the 2 groups (P>0.05). Conclusion Anticoagulants are safe and effective in the treatment of CIED-lead venous thrombosis, and the effectiveness is enhanced with prolonged treatment. Dabigatran is superior to warfarin in long-term effectiveness.