A case report of right ventricular defibrillator and left bundle branch area leads placement and atrioventricular
1Department of Hospital Medicine, Marshfield Clinic Health System, Marshfield, WI, United States.
Right ventricular thrombus is often a contraindication for device implantation. This case demonstrates successful intracardiac lead placement and ablation in a patient with chronic right ventricle thrombus, challenging current guidelines.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Right ventricular thrombus is typically viewed as a contraindication for intracardiac lead placement.
- Existing clinical guidelines lack definitive evidence to support this contraindication.
Observation:
- A patient with a chronic right ventricle thrombus required intracardiac device implantation.
- The patient underwent successful placement of a right ventricular defibrillator lead and a left bundle branch pacing lead.
Findings:
- Successful atrioventricular node ablation was performed in the presence of the thrombus.
- The patient tolerated the procedures well without immediate complications.
Implications:
- This case suggests that right ventricular thrombus may not always be an absolute contraindication for lead placement.
- Further research is needed to re-evaluate current guidelines regarding intracardiac device implantation in patients with right ventricular thrombus.
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