Patch migration: a serious late complication of thoracotomy lead systems

Thoracotomy patch leads used for implantable cardioverter defibrillators (ICDs) are generally safe and effective. We describe two patients in whom a late complication of patch lead migration occurred years after the original implants, causing a bronchopleural fistula in one and lingular lobe collapse in the other patient. We conclude that patch migration is a late but possible complication of extrapericardial ICD leads, and should be suspected in patients who present with hemoptysis, atypical pneumonia, or lung collapse after the initial ICD surgery.