CTICasesIntrathoracic Pacemaker Migration
Imaging findings
Chest CT shows an old cardiac pacemaker generator, originally implanted in 1978, that has migrated intrathoracically, breaching the parietal and visceral pleura to sit deep within the left lung parenchyma, associated with localized atelectasis and pleural thickening. A chronic weeping chest wall wound with a protruding wire is present. Follow-up radiograph post removal shows a residual calcified tract in the lung.
Key takeaways
Intrathoracic migration or erosion of a pacemaker generator is a rare late complication of subcutaneous pacemaker placement, particularly when placed in childhood. Over decades, the device can erode through the chest wall tissues and pleura to reside within the lung. Management requires surgical extraction and chest wall reconstruction to resolve chronic infection or weeping wounds.
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