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Management of Gunshot Injury Involving Cardiac Implantable Electronic Device
Saad A Ali1, Nektarios Vasilottos1, Mithilesh K Das1
1Division of Cardiovascular Medicine, Indiana University, Indianapolis, Indiana, USA.
Background:
Firearm injuries involving cardiac implantable electronic devices (CIEDs) present unique challenges.
Case Summary:
We report a case of a 69-year-old male with a self-inflicted gunshot wound to the chest, which directly damaged his implantable cardioverter-defibrillator (ICD). After we had achieved hemodynamic stability in this patient, we extracted the ICD, in which a retained bullet was discovered embedded in the ICD's circuit board. After the damaged ICD system was removed, a new system was implanted on the contralateral side.
Discussion:
This case underscores the complexities of managing firearm injuries involving CIEDs, highlighting considerations such as pacemaker dependency, infection risk, battery leakage, and procedural challenges. A multidisciplinary approach is crucial for optimal patient outcomes.
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