Dislodgement of Atrial Lead of the CRT-D System and Its Migration into the Pocket Presenting as Its Absence on Chest X-Ray (original) (raw)
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The European Research Journal
During cardiac resynchronization therapy implantation, left ventricular lead placement involves transvenous placement of leads via the coronary sinus and into a tributary branch. At present, the most widely used method for left ventricular (LV) lead placement involves a transvenous LV lead placement via the coronary sinus into a tributary branch. Lead dislodgement is a common cause for reoperation. We describe a case where a coronary stent was placed to stabilize the lead against the vessel wall.
Introduction. The inadvertent lead malposition in the left heart chambers (ILMLH) is an under-recognized event which may complicate implantation of cardiac electronic devices (CIEDs). Methods and Results. We investigated the clinical conditions associated with ILMLH and the treatment strategies in these patients. We made a systematic review of literature and identified 132 studies which reported 157 patients with ILMLH. Mean age of patients was 68 years and 83 were women. ILMLH was diagnosed, on average, 365 days after CIEDs implantation. Coexisting conditions were patent foramen ovale in 29% of patients, arterial puncture in 24%, perforation of the interatrial septum in 20%, atrial septal defect in 16% and perforation of the interventricular septum in 4%. At the time of diagnosis of ILMLH, 46% of patients were asymptomatic, 31% had acute TIA or stroke and 15% had overt heart failure. Overall, 14% of patients were receiving anticoagulants at the time of diagnosis of ILMLH. After dia...
Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 2014
The number of cardiac rhythm device implantations has been growing fast due to expanding indications and ageing of the population. Complications of implantation were rare in the trials. However, these involved small numbers and selected patients. Prospective real-life data are necessary to assess cardiac device implantation procedure-related risks. To determine the incidence and predictors of lead-related re-intervention in a Dutch high-volume teaching hospital. Data from all patients who underwent cardiac rhythm device implantation between January 2010 and December 2011 were collected in a prospective registry. At least 1 year of follow-up regarding re-intervention was available for all patients. Lead-related reasons for re-intervention were categorised into lead dislodgement, malfunctioning or perforation. One thousand nine hundred twenty-nine devices including 3909 leads were implanted. In 595 patients (30.8 %) a CRT-D/P was implanted. Lead-related re-intervention was necessary i...
Lead Removal of Cardiac Implantable Electronic Device
Indonesian Journal of Cardiology
As more people are living longer with more significant cardiac disease,permanent pacemakers (PPMs) and implantable cardioverter-defibrillators(ICDs) are being inserted more frequently each year. Beginning early in the21st century, there has also been an expansion in the indications for cardiacimplantable electronic devices (CIED, a term which includes PPMs andICDs), and device therapy has become more complex, frequently involvingmultiple leads per patient. In turn, there will be more occasion where thelead removal for these CIED will be necessary.A 6 y.o. patient was incidentally found to have a fractured pacemaker leadduring during routine x-ray for his respiratory tract infection. The pacemakerwas inserted 5 years ago, indicated for the permanent total atrioventricularblock developed after total correction surgery in Tetralogy of Fallot. Thelead fracture was thought to be caused by a phenomenon known as thesubclavian crush syndrome. A transvenous lead extraction in this patientwas...