A 16-day-old neonate with congenital complete atrioventricular block underwent epicardial pacemaker implantation under the rectus. Four months later, abodominal X-ray imaging revealed dislocation of the generator from the abdomen to the pelvis. The infant was diagnosed with intraperitoneal pacemaker dislocation. However, there were no abdominal manifestations or complications associated with the bowel, urinary tract, and vascular system. Surgical refixation was performed in a hybrid room. Fluoroscopy helped avoid bowel injury when removing the generator from the peritoneal cavity. The pacing lead, which was adherent and entangled with the omentum, was released under direct vision. The generator was placed in a new pocket created in the subcutaneous layer of the anterior fascia of the rectus.
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Pacing Clin Electrophysiol
December 2024
Department of Cardiology, Cardinal Wyszynski Hospital in Lublin, Lublin, Poland.
Background: Cardiac implantable devices (CIED) such as pacemakers, implantable cardioverter-defibrillators, or cardiac resynchronization devices are implanted in selected patients with bradyarrhythmia and advanced heart failure. The invasive character of these procedures poses a risk of early complications such as pneumothorax, bleeding, infections, or dislocations.
Aims: There are no available data that analyzed the impact of the organization of procedures on the early complications risk after permanent pacing procedures.
Cureus
July 2024
Cardiology, Hospital Clinica Benidorm (HCB), Benidorm, ESP.
Twiddler syndrome is a rare entity in which patient manipulation causes lead dislocation with lead retraction. Reel syndrome, on the other hand, is observed after external manipulation, intentional or unintentional, in which the leads move along their transverse axis and is considered a variant of Twiddler syndrome. We present the clinical case of a 91-year-old female who, after pacemaker implantation, presented with dizziness and chest discomfort following constant manipulation of the pacemaker, resulting in complete retraction of the lead tip into the pouch, which is unusual in the literature to date.
View Article and Find Full Text PDFEuropace
August 2024
HeartClinic, Hirslanden Clinic, Zurich, Switzerland.
J Cardiovasc Dev Dis
April 2024
Cardiology Center/Cardiac Electrophysiology Division, Internal Medicine Clinic, University of Szeged, 6725 Szeged, Hungary.
(1) Background: Early reintervention increases the risk of infection of cardiac implantable electronic devices (CIEDs). Some operators therefore delay lead repositioning in the case of dislocation by weeks; however, there is no evidence to support this practice. The aim of our study was to evaluate the impact of the timing of reoperation on infection risk.
View Article and Find Full Text PDFJACC Cardiovasc Interv
April 2024
Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany.
Background: Transcatheter aortic valve replacement (TAVR) is an effective and safe therapy for severe aortic stenosis. Rapid or fast pacing is required for implantation, which can be performed via a pre-existing cardiac implantable electric device (CIED). However, safety data on CIEDs for pacing in TAVR are missing.
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