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Unusual case of pacemaker lead migration

B V Dalvi1, R M Rajani, Y Y Lokhandwala

  • 1Department of Cardiology, King Edward VII Memorial Hospital, Parel, Bombay.

Insights

Pacemaker lead migration to the pulmonary artery is rare. This case shows lead migration causing septic pulmonary embolism and infarcts, highlighting a critical complication.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Radiology

Background:

  • Pacemaker lead migration into the pulmonary artery is a rare but serious complication.
  • Infection around the pacemaker lead can lead to thrombus formation and septic emboli.

Observation:

  • A patient experienced pacemaker lead migration to the right pulmonary artery.
  • This was associated with septic pulmonary embolism and multiple pulmonary infarcts.

Findings:

  • The patient was treated with intravenous Cefuroxamine.
  • During treatment, the lead spontaneously migrated to the left pulmonary artery.
  • This resulted in subsequent left pulmonary embolism.

Implications:

  • This case underscores the potential for delayed or secondary migration of pacemaker leads.
  • It highlights the risk of septic pulmonary embolism even after initial treatment.
  • Early recognition and management are crucial for patients with pacemaker lead complications.

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