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Intracardiac "Ghost" Following Implantable Cardioverter-Defibrillator (ICD) Explantation: The Role of Multimodality
Constantinos Antoniades1, Marios Ioannides1, Theodoros Christophides1
1Cardiology Department, Nicosia General Hospital, Nicosia, CYP.
Abstract:
Intracardiac "ghosts" are mobile remnants that may persist after transvenous lead extraction (TLE) and can mimic vegetations on transesophageal echocardiography. We report a 55-year-old man who underwent implantable cardioverter-defibrillator (ICD) explantation for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Post-explantation echocardiography revealed a large mobile mass attached to the tricuspid annulus and right atrial appendage. Cardiac magnetic resonance (CMR) imaging demonstrated a nonperfused structure consistent with an organized fibrotic sheath. Serial imaging showed spontaneous regression, although a small pulmonary embolism occurred. This case highlights the echocardiographic features and clinical evolution of a post-explantation "ghost."
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