CTICasesPacemaker Lead Fracture (Thoracic Outlet Compression)
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Imaging findings
Serial radiographs (2013 and 2014) of a two-lead pacemaker showed progressive thinning of the wire insulation where it crossed between the first rib and the clavicle. A year later, the insulation was clearly disrupted at this common compression point.
Key takeaways
Pacemaker lead fracture or insulation disruption can occur at common points of compression, such as where the lead passes between the clavicle and the first rib (thoracic outlet compression). This is a well-recognized mechanism of lead failure. Regular follow-up imaging is important to identify such defects, which can affect device function.
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