CTICasesEmbolized Pacing Lead Tip
Imaging findings
Chest radiograph and chest CT demonstrate a focal, dense metallic fragment lodged in a subsegmental pulmonary artery of the left lower lobe. Pre-operative imaging showed a left ventricular pacing lead, which was extracted at the time of heart transplantation.
Key takeaways
During the extraction of cardiac implantable electronic devices (CIEDs), particularly transvenous pacing leads that have become endothelialized, fragments of the lead tip can break off. These fragments can embolize through the right heart into the pulmonary arterial circulation, where they typically remain lodged and are managed conservatively.
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