1
|
Tokuda M, Yamane T, Sadaoka S, Tokutake K, Yokoyama K, Hioki M, Narui R, Tanigawa S, Inada K, Matsuo S, Yoshimura M. Percutaneous retrieval of a radiolucent anchoring sleeve embolized in pulmonary artery during pacemaker implantation. Heart Vessels 2015; 31:1402-4. [PMID: 26391679 DOI: 10.1007/s00380-015-0747-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/09/2015] [Indexed: 10/23/2022]
Abstract
An 85-year-old female presented to our institution with symptomatic sick sinus syndrome. During pacemaker implantation, an anchoring sleeve in the right ventricular lead was embolized in the left pulmonary artery. Although the anchoring sleeve was radiolucent, digital subtraction angiography revealed an angiographic filling defect in the lower branch of the left pulmonary artery, and a snare catheter enabled the anchoring sleeve to be grasped and extracted.
Collapse
Affiliation(s)
- Michifumi Tokuda
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Teiichi Yamane
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shunichi Sadaoka
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Tokutake
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenichi Yokoyama
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mika Hioki
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryohsuke Narui
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shinichi Tanigawa
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Keiichi Inada
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Seiichiro Matsuo
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michihiro Yoshimura
- Department of Cardiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| |
Collapse
|
2
|
Guler A, Karabay CY, Aung SM, Pala S, Kirma C. A successful percutaneous retrieval of a fractured pacemaker lead from a segmental pulmonary artery. Europace 2011; 14:605. [PMID: 21969527 DOI: 10.1093/europace/eur317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A rarely reported complication of pacemaker lead extraction is embolization of the pulmonary vasculature by a fragmented lead tip. The tip fractured and migrated to the right pulmonary artery during the extraction, and it was successfully retrieved percutaneously. Percutaneous retrieval is an important treatment option of an embolized fragmented lead tip as it could sometimes lead to disastrous complications.
Collapse
Affiliation(s)
- Ahmet Guler
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, Cardiology Clinic, Kartal, Istanbul, Turkey
| | | | | | | | | |
Collapse
|
4
|
GOLZIO PIERGIORGIO, BONGIORNI MARIAGRAZIA, GIUGGIA MARCO, VINCI MELISSA, GAZZERA CARLO, BREATTA ANDREADORIGUZZI. Retrieval of Pacemaker Lead Tip Embolized into the Distal Pulmonary Arterial Bed during Extraction Procedure. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2007; 30:1558-61. [DOI: 10.1111/j.1540-8159.2007.00907.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
5
|
Golzio PG, Bongiorni MG, Chiribiri A, Franco E. Extraction of the Inner Coil of a Pacemaker Lead Slid into the Pulmonary Artery. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2007; 30:273-5. [PMID: 17338727 DOI: 10.1111/j.1540-8159.2007.00661.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A patient required lead extraction for chronic draining sinus, due to abandoned leads. Preoperatively, the chest film showed a filament in the right pulmonary artery: it was the inner coil of an old atrial lead that, while remaining anchored to the auricle, slid outside the outer coil. By right subclavian approach, the old ventricular lead and the outer coil of the atrial lead were removed. Then, by right jugular approach, the freely floating end of the inner atrial coil was grasped by a pig-tail catheter, drawn back into the superior vena cava, exteriorized by a Lasso catheter, and finally extracted.
Collapse
Affiliation(s)
- Pier Giorgio Golzio
- Cardiology Division, Department of Internal Medicine, University of Torino, Torino, Italy.
| | | | | | | |
Collapse
|
6
|
Eckart RE, Hruczkowski TW, Landzberg MJ, Ames A, Epstein LM. Pulmonary Arterial Embolization of Pacemaker Lead Electrode Tip. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2006; 29:784-7. [PMID: 16884517 DOI: 10.1111/j.1540-8159.2006.00435.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Complications with extraction of abundant endovascular systems increase with time since implantation. As the number of implanted devices increases, successful management of complications needs to be disseminated. We present a 46-year-old woman with endovascular leads placed 15 years previously requiring extraction. Using laser-assistance the leads were removed, although the passive lead tips were unable to be extracted, and were retained in the superior vena cava. One lead tip embolized to the distal pulmonary bed within 24 hours of her operative procedure. Computed tomography and pulmonary arteriography suggested a near immediate thrombogenic process. A multidisciplinary approach was utilized to identify management strategies that allowed for a satisfactory patient outcome.
Collapse
Affiliation(s)
- Robert E Eckart
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
| | | | | | | | | |
Collapse
|
7
|
Hreybe H, Barrington W, Ganz LI, Saba S. Heart Failure and Pulmonary Embolism:. The Story of the Third Lead. Pacing Clin Electrophysiol 2004; 27:1306-9. [PMID: 15461722 DOI: 10.1111/j.1540-8159.2004.00623.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Haitham Hreybe
- Section of Cardiac Electrophysiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA
| | | | | | | |
Collapse
|
8
|
Theres H, Sun W, Combs W, Panken E, Mead H, Baumann G, Stangl K. P wave and far-field R wave detection in pacemaker patient atrial electrograms. Pacing Clin Electrophysiol 2000; 23:434-40. [PMID: 10793430 DOI: 10.1111/j.1540-8159.2000.tb00823.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study was undertaken to develop and test a morphology-based adaptive algorithm for real-time detection of P waves and far-field R waves (FFRWs) in pacemaker patient atrial electrograms. Cardiac event discrimination in right atrial electrograms has been a problem resulting in improper atrial sensing in implantable devices; potentially requiring clinical evaluation and device reprogramming. A morphology-based adaptive algorithm was first evaluated with electrograms recorded from 25 dual chamber pacemaker implant patients. A digital signal processing (DSP) system was designed to implement the algorithm and test real-time detection. In the second phase, the DSP implementation was evaluated in 13 patients. Atrial and ventricular electrograms were processed in real-time following algorithm training performed in the first few seconds for each patient. Electrograms were later manually annotated for comparative analysis. The sensitivity for FFRW detection in the atrial electrogram during off-line analysis was 92.5% (+/- 10.9) and the positive predictive value was 99.1% (+/- 1.8). Real-time P wave detection using a DSP system had a sensitivity of 98.9% (+/- 1.3) and a positive predictivity of 97.3% (+/- 3.5). FFRW detection had a sensitivity of 91.0% (+/- 12.4) and a positive predictivity of 97.1% (+/- 4.2) in atrial electrograms. DSP algorithm tested can accurately detect both P waves and FFRWs in right atrium real-time. Advanced signal processing techniques can be applied to arrhythmia detection and may eventually improve detection, reduce clinician interventions, and improve unipolar and bipolar lead sensing.
Collapse
Affiliation(s)
- H Theres
- Medical Clinic I, Charité Hospital, Berlin, Germany.
| | | | | | | | | | | | | |
Collapse
|