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Updated: Jun 24, 2026
06:03
Electrolytic Inferior Vena Cava Model (EIM) of Venous Thrombosis
Published on: July 12, 2011
[The floating structure connected with endocavitary electrode--thrombus or bacterial vegetation?].
Janusz Cieślewicz1, Aneta I Gziut
1Klinika Kardiologii Inwazyjnej, Centralny Szpital Kliniczny MSWiA, ul. Wołoska 137, 02-507 Warszawa.
Kardiologia Polska
|March 17, 2009
Summary
A pacemaker lead complication was identified as a thrombus, not bacterial vegetation, in a patient with complete atrioventricular block. Anticoagulant therapy with heparin and warfarin successfully resolved the thrombus.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Diagnostic Imaging
Background:
- Complete atrioventricular block necessitates pacemaker implantation for hemodynamic stability.
- Endocavitary electrodes are standard in pacemaker systems for pacing and sensing.
- Routine echocardiography is crucial for monitoring pacemaker function and detecting complications.
Observation:
- A 52-year-old woman presented with a complete atrioventricular block, successfully treated with pacemaker implantation.
- Transthoracic echocardiography revealed an unusual floating structure attached to the endocavitary electrode.
- Differential diagnosis included infective endocarditis (bacterial vegetation) versus a thrombus.
Findings:
- Diagnostic workup excluded bacterial vegetation as the cause of the observed structure.
- The floating structure was definitively diagnosed as a thrombus associated with the pacemaker lead.
- The patient's condition was managed successfully with anticoagulation therapy.
Implications:
- This case highlights the importance of echocardiography in identifying pacemaker lead complications.
- Thrombus formation on pacemaker leads, though rare, requires prompt diagnosis and management.
- Effective anticoagulation strategies can successfully treat pacemaker lead-associated thrombi, avoiding surgical intervention.
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