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Coronary sinus pacer lead simulating left atrial mass.
E Hanabergh1, A Rahim, A Agatston
1Department of Internal Medicine, Mount Sinai Medical Center of Greater Miami, Fla.
Summary
Echocardiography revealed an echo-producing mass in the left atrium of a rheumatic heart disease patient with a coronary sinus lead. The mass disappeared after replacing the lead with a right atrial screw-in lead.
Area of Science:
- Cardiology
- Medical Imaging
- Cardiac Electrophysiology
Background:
- Rheumatic heart disease can cause cardiac complications.
- Atrioventricular sequential pacing is used to manage bradyarrhythmias.
- Coronary sinus leads are utilized in specific pacing scenarios.
Observation:
- An echo-producing mass was identified in the left atrium during echocardiography.
- The patient had a history of rheumatic heart disease and an existing pacemaker with a coronary sinus lead.
Findings:
- The left atrial mass was visualized using M-mode and two-dimensional echocardiography.
- A repeat echocardiographic study was performed after lead replacement.
- The echo-producing mass was no longer visible after the coronary sinus lead was exchanged for a right atrial screw-in lead.
Implications:
- Pacemaker lead placement may influence intracardiac mass formation or visualization.
- Further investigation is warranted to determine the nature of the mass and its relationship to the lead.
- This finding highlights the importance of considering lead type and position in echocardiographic assessments.