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Peripheral migration of pacemaker electrodes.

W D Widmann, J K Edoga, D Garfias

    Pacing and Clinical Electrophysiology : PACE
    |March 1, 1984
    PubMed
    Summary
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    A migrated pacemaker electrode fragment caused severe leg vein inflammation. Surgical removal and vena cava plication successfully resolved the phlebitis, highlighting a rare complication of cardiovascular implantable electronic devices.

    Area of Science:

    • Cardiology
    • Vascular Surgery
    • Medical Device Complications

    Background:

    • Pacemaker implantation is common, but complications can arise.
    • Foreign body migration from venous access sites is a recognized, albeit infrequent, occurrence.
    • Ileo-femoral phlebitis presents significant morbidity.

    Observation:

    • A 55-year-old male presented with acute right ileo-femoral phlebitis.
    • Imaging revealed a migrated, unused pacemaker electrode fragment lodged in the right iliac vein, originating from the right subclavian vein.
    • The electrode's exposed metal coil was noted.

    Findings:

    • Surgical intervention included vena cava plication and successful retrieval of the electrode fragment.
    • Complete resolution of the ileo-femoral phlebitis was achieved post-operatively.

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  • The exposed metal coil of the electrode fragment was suspected as a contributing factor to the severe inflammatory response.

    • Implications:

    • This case underscores the potential for delayed complications from cardiovascular implantable electronic device fragments.
    • Prompt diagnosis and surgical management are crucial for resolving such rare embolic events.
    • Further investigation into the inflammatory potential of exposed pacemaker electrode materials may be warranted.