An Unusual Case of Multiple Right Atrial Thrombi in a Patient with a Dual-Chamber Pacemaker

Schifter, David; Kozer, Leonid M.; Saul, Barry I.; Reddy, C.V.R.

doi:10.1177/000331979905001010

Cited by 10 publications

(8 citation statements)

References 10 publications

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“…Atrial thrombus is associated with structural cardiac disease such as hypertrophic cardiomyopathy, atrial fibrillation and metastatic carcinoma, valve stenosis . These may leads to stroke or 2016; 6(case reports): [5][6][7][8] Deser pulmonary embolism. Incidense of atrial fibrillation with stroke is between 5% and 12% per year (4).…”

Section: Discussionmentioning

confidence: 99%

Atrial Trombektomi ile Tedavi Edilen Pacemaker Lead Trombozu

Deşer¹,

Demirağ²

2016

J Contemp Med

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Sağ atrium trombozu ve pulmoner emboli pacemaker konulması sonrasında görülen nadir komplikasyonlardır. Sağ atrial trombüse bağlı akut pulmoner emboli hemodinamik bozukluk, konjestif kalp yetmezliği ve yüksek mortalite oranı ile ilişkilidir. Erken tanı ve girişim önemlidir. Biz burada endokardial DDD pacemaker lead trombüsü ve ileri triküspit kapak yetmezliği olan bir hastanın cerrahi tedavisini sunduk. Anahtar Kelimeler: Pacemaker; trombüs; tedavi; cerrahi. Right atrial thrombosis and pulmonary embolism are infrequent complications of pacemaker insertion. Acute pulmonary embolism due to right atrial thrombus is related with haemodynamic compromise, congestive heart failure and high mortality rate. Prompt diagnose and intervention is essential. We report surgical treatment of a patient with a large thrombus on an endocardial DDD pacing lead and severe tricus-pid insufficiency.

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Section: Discussionmentioning

confidence: 99%

Atrial Trombektomi ile Tedavi Edilen Pacemaker Lead Trombozu

Deşer¹,

Demirağ²

2016

J Contemp Med

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“…Anticoagulation is more likely to be considered in the stable patient. Factors predisposing individuals to development of pacemaker lead thrombosis include congestive heart failure and hypercoagulable states (2). Diagnosis is rarely made in the ED, because it is such a rare condition with a nonspecific clinical presentation.…”

Section: Discussionmentioning

confidence: 99%

Right Atrial Thrombus Secondary to Pacemaker Wires

Feuchter

Katz

2012

The Journal of Emergency Medicine

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“…Serious thrombotic and embolic complications are reported to occur in 0.6 to3.5 percent of patients with permanent transvenous pacing leads [5]. The cases usually describe PM-associated thrombosis [6], and less frequently right atrial PM lead thrombosis [7]. In patients with a mobile RH thrombus, the incidence of pulmonary embolism is 97 percent and reported mortality is over 44 percent [8].…”

Section: Discussionmentioning

confidence: 99%

The first three-dimensional visualization of a thrombus in transit trapped between the leads of a permanent dual-chamber pacemaker: a case report

et al. 2010

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IntroductionTwo-dimensional echocardiography is a useful tool in diagnosing cardiac masses. However, the three-dimensional offline reconstruction technique of transesophageal echocardiography might be superior to two-dimensional transesophageal echocardiography in providing additional information of structural details.Case presentationWe report the case of a 76-year-old Caucasian man with a permanent dual-chamber pacemaker and a worm-like right-heart thrombus in transit. Two-dimensional transthoracic echocardiography and two-dimensional transesophageal echocardiography showed that it was debatable as to whether "the worm" was originating from the leads. Offline three-dimensional transesophageal echocardiography reconstruction technique proved superior in identifying the cardiac mass as a thrombus trapped between the leads of the pacemaker. The thrombus was successfully dissolved by systemic heparin therapy.ConclusionsThe three-dimensional transesophageal echocardiography is useful and effective in patients with implanted pacemakers or defibrillators when other closely competing imaging modalities are contraindicated, such as magnetic resonance imaging. In patients with pacemakers and trapped thrombus in transit for whom surgical therapy might be a high risk, medical therapy seems to offer a safer and convincing alternative. Whether the management of right-heart thrombi has to be modified due to the presence of pacemaker leads is controversial.

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An Unusual Case of Multiple Right Atrial Thrombi in a Patient with a Dual-Chamber Pacemaker

Abstract: The authors present an unusual case of multiple large atrial thrombi attached to permanent pacemaker leads identified by transesophageal echocardiography. Pathogenesis, clinical implications, and therapeutic options of pacemaker thrombi are discussed.

Cited by 10 publications

References 10 publications

Atrial Trombektomi ile Tedavi Edilen Pacemaker Lead Trombozu

Atrial Trombektomi ile Tedavi Edilen Pacemaker Lead Trombozu

Right Atrial Thrombus Secondary to Pacemaker Wires

The first three-dimensional visualization of a thrombus in transit trapped between the leads of a permanent dual-chamber pacemaker: a case report

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