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Patch migration: a serious late complication of thoracotomy lead systems
I Singer1, N Calzada, E H Austin
1Division of Cardiology, University of Louisville, Kentucky 40292, USA.
Late migration of extrapericardial implantable cardioverter defibrillator (ICD) patch leads can cause serious complications years after implantation. Suspect patch migration in patients with unexplained lung issues post-ICD surgery.
Area of Science:
- Cardiology
- Thoracic Surgery
- Medical Device Complications
Background:
- Implantable cardioverter defibrillators (ICDs) utilize patch leads for effective cardiac rhythm management.
- Extrapericardial patch leads are generally considered safe and reliable for ICD implantation.
Observation:
- Two cases of late-onset complications related to thoracotomy patch leads are presented.
- These complications occurred years after the initial ICD implantation procedures.
Findings:
- Patch lead migration was identified as the cause of severe late complications.
- One patient developed a bronchopleural fistula, while the other experienced lingular lobe collapse due to lead migration.
Implications:
- Patch lead migration is a potential, albeit uncommon, late complication of extrapericardial ICD leads.
- Clinicians should consider patch migration in patients presenting with hemoptysis, atypical pneumonia, or lung collapse post-ICD surgery.
- This highlights the importance of long-term monitoring for device-related complications.
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