CTICasesPacemaker Lead Complications (Shredded/Stuck Lead and Broken Lead Fragment)
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Imaging findings
Chest radiograph post-pacemaker procedure shows a left pectoral pacemaker with atrial and ventricular leads. An anomalous, shredded-appearing remnant of a pacemaker lead is seen, having drifted down the inferior vena cava (IVC). Historical images reveal an atrial lead with an acute bend in close proximity to the tricuspid valve. A separate case shows a small, shredded fragment of a pacemaker lead remaining in the right atrium after an attempted extraction.
Key takeaways
Pacemaker lead extraction can be complicated by leads becoming adherent to cardiac structures (e.g., tricuspid valve apparatus), leading to shredding and incomplete removal. Broken lead fragments can be left in situ if retrieval is difficult or prolonged. Recognition of these findings on imaging is crucial for management planning.
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See all cases from June 12, 2015 →