Inferior vena cava thrombosis due to migration of retained functionless pacemaker electrode

Area of Science:

• Cardiology
• Vascular Surgery
• Medical Device Complications

Background:

• Pacemaker implantation is a common procedure for cardiac rhythm management.
• Retained or migrated pacemaker leads are known complications.
• Inferior vena cava (IVC) thrombosis is a serious condition with significant morbidity.

Observation:

• A case of inferior vena cava (IVC) thrombosis was identified.
• The thrombosis was directly linked to a migrated pacemaker electrode.
• The distal end of the retained electrode was found looped within the thrombosed IVC segment.

Findings:

• This represents the first reported instance of IVC thrombosis caused by pacemaker wire migration.
• The patient was successfully managed with anticoagulation, initially with heparin and subsequently with coumadin.
• The patient experienced a favorable outcome with no recurrence of thromboembolic complications.

Implications:

• Highlights a rare but serious complication of pacemaker lead management.
• Emphasizes the importance of careful lead placement and retrieval.
• Suggests anticoagulation as an effective treatment strategy for this specific complication.