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Late endocardial pacing lead body migration compromising Fontan physiology
B K O'Connor1, C L Case, M M Wienecke
1South Carolina Children's Heart Center, Medical University of South Carolina, Charleston, USA.
Pacing and Clinical Electrophysiology : PACE
|December 1, 1996
Summary
Intracardiac pacing leads can migrate, posing risks. A case report details late intrapulmonary migration of an atrial pacing lead body, causing severe blood flow obstruction and cardiac decompensation, which was resolved by repositioning.
Area of Science:
- Cardiology
- Medical Device Technology
- Cardiac Electrophysiology
Background:
- Intracardiac transvenous pacing leads are essential for managing cardiac arrhythmias.
- Lead migration is a recognized complication, particularly intrapulmonary migration of ventricular leads in endocardial systems.
Observation:
- This report details a rare instance of late intrapulmonary migration of an endocardial atrial pacing lead body.
- The patient had a history of antitachycardia pacemaker placement post-Fontan procedure for atrial tachyarrhythmias.
Findings:
- Despite the lead electrode remaining functional, the lead body migrated significantly.
- This migration caused severe obstruction of blood flow within the pulmonary vasculature.
- The patient experienced severe cardiac decompensation as a direct result of the lead migration.
Implications:
- This case highlights the potential for atrial lead body migration, not just ventricular leads.
- Prompt diagnosis and intervention, such as lead repositioning, are crucial for managing such complications.
- Awareness of this complication is important for clinicians managing patients with pacemakers, especially post-Fontan procedure.