Pacemaker lead-associated thrombosis in cardiac resynchronisation therapy
Open accessAbstract
Pacemaker lead-associated thrombosis is a possible complication of any cardiac implantable electronic device. We present a case of a middle-aged woman with a history of ischaemic left ventricular failure, who presented with fever and other non-specific symptoms 4 months after cardiac resynchronisation therapy. A transoesophageal echocardiogram confirmed a vegetation-like structure originating from the pacemaker lead in the right atrium. The patient was treated with intravenous antibiotics followed by open heart surgery in order to remove this mass as well as the pacing device, including all three pacing leads. Histology and culture of the retrieved mass confirmed a sterile thrombus with no features to suggest an infected mass (vegetation). The patient made an uncomplicated recovery and there were no long-term sequelae on follow-up during the 2 years after the event.
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Transvenous leads are linked to complications including lead dislodgement, tricuspid valve dysfunction, and thromboembolism.
“Transvenous leads are also associated with various complications such as lead dislodgement15, tricuspid valve dysfunction16, and thromboembolism17, etc., which would be solved with leadless pacemaker technologies18–20.”
From Synchronized Biventricular Heart Pacing in a Closed-chest Porcine Model based on Wirelessly Powered Leadless Pacemakers (2020) · cites this paper as [17]
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- Authors
- Buttigieg, J., Asciak, R., & Mallia Azzopardi, C.
- Affiliations
- Mater Dei Hospital (MT)
- Department of Internal Medicine and Infectious Diseases Medicine, Mater Dei Hospital, Msida, Malta
- Corresponding author
- Asciak, Rachelle
- Venue
- BMJ Case Reports
- Publisher
- BMJ
- Published
- 2015-07-07
- Volume
- 2015
- Pages
- bcr2015210314
- ISSN
- 1757-790X (ISSN-L)
- PMC
- PMC4499717
- OpenAlex
- W1802341058
- Cited by
- 12
- References
- 22
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 1
- FWCI
- 0.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ Case Reports (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac tumors and thrombi
- Keywords
- cardiac resynchronization therapy, cardiac implantable electronic devices, right atrium, transesophageal echocardiography, antibiotic therapy
- MeSH terms
- Anti-Bacterial Agents, Female, Fever, Heart Atria, Humans, Middle Aged, Pacemaker, Artificial, Thrombosis, Treatment Outcome, Defibrillators, Implantable, Echocardiography, Transesophageal, Cardiac Resynchronization Therapy
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