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Related Concept Videos

Types of Reports I: Hand-off Report01:25

Types of Reports I: Hand-off Report

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A hand-off report, also known as a change-of-shift report, is a crucial nursing process that ensures the smooth transition of patient care responsibilities between nursing staff.
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Related Experiment Video

Updated: May 3, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Case report: accidental finding of mobile pacemaker lead structures.

Dora Philips1, Daniëlle V J Zaar2, Rik Willems3

  • 1Department of Cardiovascular Sciences, KU Leuven and Cardiology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium.

Acta Cardiologica
|February 5, 2024
PubMed
Summary
This summary is machine-generated.

Mobile structures on pacemaker leads, suspected to be thrombus, were observed in a patient with atrial fibrillation. Switching anticoagulation medication led to a decrease in structure size, suggesting a non-infectious etiology.

Keywords:
Cardiologyechographyendocarditispacemakerpacemakerlead trombi

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Area of Science:

  • Cardiology
  • Vascular Medicine
  • Medical Imaging

Background:

  • Atrial fibrillation management often involves anticoagulation and pacemaker implantation.
  • Mobile structures on pacemaker leads can be incidentally discovered.
  • Distinguishing between thrombus and infectious endocarditis is clinically significant.

Observation:

  • A 79-year-old male on apixaban for atrial fibrillation presented with multiple ischemic strokes.
  • Transesophageal echocardiography revealed mobile structures on his pacemaker lead.
  • Infectious endocarditis was ruled out by Modified Duke Criteria and negative blood cultures.

Findings:

  • The mobile structures, suspected to be thrombus, decreased in size after switching anticoagulation from apixaban to dabigatran.
  • Patent foramen ovale and pulmonary arteriovenous malformations were excluded as stroke causes.
  • The structures were deemed unlikely to be vegetations from infectious endocarditis due to lack of fever and inflammatory markers.

Implications:

  • This case highlights the diagnostic challenge of mobile pacemaker lead structures.
  • Further research is needed to determine the clinical relevance and optimal treatment for these incidental findings.
  • Understanding the nature of these structures is crucial for preventing thromboembolic events.