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Delayed management of atrial lead dislodgment after pacemaker implantation: a case report
BACKGROUND: Pacemaker lead dislodgement may cause malfunction in the pacing system, which may lead to severe adverse events. For patients with sick sinus syndrome but normal atrioventricular conduction, atrial lead dislocation may cause excessive unnecessary ventricular pacing, resulting in nonphysi...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807897/ https://www.ncbi.nlm.nih.gov/pubmed/33441160 http://dx.doi.org/10.1186/s13256-020-02626-z |
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author | Guan, Fu Li, Guangping Liu, Yong Gao, Xing Zhou, Rui |
author_facet | Guan, Fu Li, Guangping Liu, Yong Gao, Xing Zhou, Rui |
author_sort | Guan, Fu |
collection | PubMed |
description | BACKGROUND: Pacemaker lead dislodgement may cause malfunction in the pacing system, which may lead to severe adverse events. For patients with sick sinus syndrome but normal atrioventricular conduction, atrial lead dislocation may cause excessive unnecessary ventricular pacing, resulting in nonphysiological pacing leading to heart failure. The longer the unwanted ventricular pacing continues, the greater the chances that irreversible heart failure may occur. Ironically, we admitted a patient who had been refusing dislodged lead relocation for 7 years. The symptoms of heart failure were significantly resolved after new atrial lead implantation. We reviewed her clinical data before and after the procedure and believed the case was worthy of reflection. CASE PRESENTATION: An 83-year-old Han Chinese woman presented with heart failure symptoms for 7 years due to the late macro-dislodgement of an atrial pacing lead. Her echocardiogram showed average left ventricular ejection fraction (LVEF) but reduced left ventricular end-diastolic volume (LVEDV) during right ventricular pacing, indicating heart failure with preserved ejection fraction (HFpEF). After 7 years of refusal, she finally agreed to implantation of a new atrial lead. She has been doing well since the operation. CONCLUSIONS: For patients with sick sinus syndrome with dual-chamber pacemaker indication, atrial lead dislodgement should be appropriately managed if the atrioventricular function is normal. As the consequences are subtle and appear gradually, they might be overlooked by patients and even doctors. Implanting a new atrial lead is the right thing to do rather than just passively waiting or treating with symptom relief medications. |
format | Online Article Text |
id | pubmed-7807897 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-78078972021-01-15 Delayed management of atrial lead dislodgment after pacemaker implantation: a case report Guan, Fu Li, Guangping Liu, Yong Gao, Xing Zhou, Rui J Med Case Rep Case Report BACKGROUND: Pacemaker lead dislodgement may cause malfunction in the pacing system, which may lead to severe adverse events. For patients with sick sinus syndrome but normal atrioventricular conduction, atrial lead dislocation may cause excessive unnecessary ventricular pacing, resulting in nonphysiological pacing leading to heart failure. The longer the unwanted ventricular pacing continues, the greater the chances that irreversible heart failure may occur. Ironically, we admitted a patient who had been refusing dislodged lead relocation for 7 years. The symptoms of heart failure were significantly resolved after new atrial lead implantation. We reviewed her clinical data before and after the procedure and believed the case was worthy of reflection. CASE PRESENTATION: An 83-year-old Han Chinese woman presented with heart failure symptoms for 7 years due to the late macro-dislodgement of an atrial pacing lead. Her echocardiogram showed average left ventricular ejection fraction (LVEF) but reduced left ventricular end-diastolic volume (LVEDV) during right ventricular pacing, indicating heart failure with preserved ejection fraction (HFpEF). After 7 years of refusal, she finally agreed to implantation of a new atrial lead. She has been doing well since the operation. CONCLUSIONS: For patients with sick sinus syndrome with dual-chamber pacemaker indication, atrial lead dislodgement should be appropriately managed if the atrioventricular function is normal. As the consequences are subtle and appear gradually, they might be overlooked by patients and even doctors. Implanting a new atrial lead is the right thing to do rather than just passively waiting or treating with symptom relief medications. BioMed Central 2021-01-14 /pmc/articles/PMC7807897/ /pubmed/33441160 http://dx.doi.org/10.1186/s13256-020-02626-z Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Guan, Fu Li, Guangping Liu, Yong Gao, Xing Zhou, Rui Delayed management of atrial lead dislodgment after pacemaker implantation: a case report |
title | Delayed management of atrial lead dislodgment after pacemaker implantation: a case report |
title_full | Delayed management of atrial lead dislodgment after pacemaker implantation: a case report |
title_fullStr | Delayed management of atrial lead dislodgment after pacemaker implantation: a case report |
title_full_unstemmed | Delayed management of atrial lead dislodgment after pacemaker implantation: a case report |
title_short | Delayed management of atrial lead dislodgment after pacemaker implantation: a case report |
title_sort | delayed management of atrial lead dislodgment after pacemaker implantation: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807897/ https://www.ncbi.nlm.nih.gov/pubmed/33441160 http://dx.doi.org/10.1186/s13256-020-02626-z |
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