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A case of cardiac strangulation following epicardial pacemaker implantation

Chihiro Miyagi1, Yoshie Ochiai2, Yusuke Ando1

  • 1Department of Cardiovascular Surgery, Japan Community Health Care Organization (JCHO), Kyushu Hospital, 1-8-1, Kishinoura, Yahatanishi-ku, Kitakyushu, 806-8501, Japan.

General Thoracic and Cardiovascular Surgery
|April 10, 2020
PubMed

Insights

A rare case of cardiac strangulation caused by a pacemaker lead in a child with congenital heart block is presented. Surgical intervention successfully removed the lead and implanted a new system, preventing recurrence.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Electrophysiology
  • Cardiovascular Surgery

Background:

  • Congenital complete atrioventricular block requires pacemaker implantation.
  • Permanent epicardial pacemaker leads can pose long-term risks.

Observation:

  • An 8-year-old boy with a history of congenital heart block presented with pulmonary and mitral stenosis.
  • Echocardiography, CT, and cardiac catheterization revealed pacemaker lead encirclement of the heart, termed "cardiac strangulation".

Findings:

  • The patient underwent removal of the constricting pacemaker lead and generator.
  • A new dual-chamber epicardial pacing system was implanted.
  • An expanded polytetrafluoroethylene sheet was used to prevent lead adherence and recurrence.

Implications:

  • This case highlights a rare but serious complication of epicardial pacemaker leads in pediatric patients.
  • Careful lead placement and follow-up are crucial in managing congenital heart block.
  • Surgical techniques can effectively address and prevent cardiac strangulation complications.

Keywords:
Cardiac strangulationEpicardial pacemakerPediatric

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