CTICasesIatrogenic Pacemaker Lead Dislodgement during TAVR
Imaging findings
Serial fluoroscopic cine images during a transcatheter aortic valve replacement (TAVR) show dislodgement of a temporary right ventricular pacing lead. The lead loops around the TAVR delivery catheter and is pulled retrograde into the inferior vena cava. Abdominal CT scout view shows the lead extending down the IVC.
Key takeaways
Temporary pacemaker leads are often placed prophylactically during TAVR to manage rapid pacing. TAVR delivery catheters can inadvertently entangle or catch the pacing lead during deployment or catheter withdrawal, leading to lead dislodgement into the IVC, which can be easily overlooked if the abdomen/pelvis scout view is not reviewed.
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