Migration of retained pacemaker electrodes

Pacemaker lead induced inferior vena caval thrombosis leading to portal hypertension

Inferior vena caval thrombosis is an unusual complication of permanent pacemaker implantation. The clinical presentation due to thrombosis depends on the site of thrombus. We have described here a rare case of pacemaker lead associated thrombosis of inferior vena cava, its diagnostic work up and briefly reviewed the existing literature of this uncommon complication.

Peripheral pulmonary migration of a retained pacemaker lead

We report a case of lead migration into the right middle pulmonary lobe. The migrated electrode reached the pleura and produced severe pleural symptoms, therefore, surgical removal of the retained lead was required. This case report demonstrates the importance of a chest X ray in the follow-up of patients with an implanted pacemaker to detect complications like lead fracture or migration.

Late endocardial pacing lead body migration compromising Fontan physiology

Migration of intracardiac transvenous pacing leads may occur. There is a known risk of intrapulmonary ventricular pacing lead migration in patients with endocardial lead systems. In the current report we present the late intrapulmonary migration of an endocardial atrial pacing lead body. The patient had undergone antitachycardia pacemaker placement to control recurrent atrial tachyarrhythmias following the Fontan procedure. Although the lead electrode remained in place and continued to pace, the lead body migrated, causing severe obstruction to blood flow. This resulted in severe cardiac decompensation, which was ultimately ameliorated by lead repositioning.

Intrapulmonary artery coiling of a permanent pacing lead

Intrapulmonary artery displacement of a permanent ventricular lead is reported to be a severe form of lead coiling and is attributed to the failure of the fixation procedure. The lead instability indicated a need for surgical correction.

Extraction of an intravascularized pacemaker lead--a new approach to an unusual problem

A new catheter approach to removing an intravascularized, nonfunctional pacemaker lead which was fixed at both distal (right ventricular endocardium) and proximal (brachiocephalic vein/superior vena cava) ends is described. This case also emphasizes the need for removal of an old pacemaker lead that caused bacteremia in a patient with a prosthetic aortic valve even when infection was presumed to be cured.