Loss of Left Ventricular Epicardial Lead Capture Due to Pneumothorax

Blommaert, Dominique; Deprez, Frédéric; Eucher, Philippe; Mancini, Isabelle; Mucumbitsi, Joseph; Collet, Benoit; Roy, Luc De

doi:10.1046/j.1460-9592.2002.00996.x

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…10 While these studies involved complications in pediatric patients with congenital heart disease, [8][9][10] there are also reports of epicardial lead malfunction in adult patients. [11][12][13] This relatively rare scenario most often results from damage to the lead at the time of implant or mechanical stress placed on the lead over time. In our patient's case, the intermittent nature of the patient's symptoms and the normal values transmitted from his remote monitor as well as the results of the in-office interrogations and fluoroscopic imaging suggest the occurrence of an acute/subacute incomplete fracture.…”

Section: Discussionmentioning

confidence: 99%

Intermittent Epicardial Lead Failure Detected Using a Continuous Ambulatory Electrocardiogram Monitor

Gabriels¹,

Ruíz-Morales²,

Tischler³

et al. 2021

J Innov Cardiac Rhythm Manage.

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A 69-year-old man received epicardial pacing leads for complete atrioventricular block that occurred during a mechanical tricuspid valve replacement procedure. During follow-up, the patient reported intermittent episodes of dizziness and bradycardia. Remote transmissions and device interrogations failed to elucidate the cause of his symptoms. A continuous ambulatory electrocardiogram (ECG) monitor was used as an alternative diagnostic tool. Multiple pauses were detected by the monitor and, upon review, these events were deemed to be due to the intermittent loss of capture by the epicardial lead. Once this diagnosis was made and the malfunctioning lead was replaced, the patient's symptoms resolved. This case highlights the novel use of a continuous ambulatory ECG monitor in diagnosing intermittent loss of capture, which was not detected by remote monitoring or device interrogations.

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Section: Discussionmentioning

confidence: 99%

Intermittent Epicardial Lead Failure Detected Using a Continuous Ambulatory Electrocardiogram Monitor

Gabriels¹,

Ruíz-Morales²,

Tischler³

et al. 2021

J Innov Cardiac Rhythm Manage.

View full text Add to dashboard Cite

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“…Tension pneumothorax not only interferes with pacemaker capture [13] but also increases the threshold of ventricular defibrillation during testing at the time of device implantation [14], necessitating prompt recognition and drainage. Astridge et al [15] reported high impedance due to pneumothorax during implantation of a monophasic defibrillator system with endocardial leads and a subcutaneous patch, causing high defibrillation thresholds which improved after resolution of the pneumothorax.…”

Section: Discussionmentioning

confidence: 99%

“…The increased threshold to defibrillation following pneumothorax has been postulated to result from the increased impedance to current flow through the chest imposed by air, especially in a left-sided pneumothorax, which can act as an insulator and consequently raise the DFT [13]; whether threshold elevation is proportional to the size of the pneumothorax is uncertain. Moreover, a pneumothorax or a large pleural effusion may alter the shock impedance and the shock vector, causing high DFT [20].…”

Section: Discussionmentioning

confidence: 99%

Traumatic Tension Pneumothorax as a Cause of ICD Failure: A Case Report and Review of the Literature

Haq

Omar

2014

Case Reports in Cardiology

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Background. Tension pneumothorax can infrequently cause ventricular arrhythmias and increase the threshold of defibrillation. It should be suspected whenever there is difficulty in defibrillation for a ventricular arrhythmia. Purpose. To report a case of traumatic tension pneumothorax leading to ventricular tachycardia and causing defibrillator failure. Case. A 65-year-old African-American female was brought in to our emergency department complaining of dyspnea after being forced down by cops. She had history of mitral valve replacement for severe mitral regurgitation and biventricular implantable cardioverter defibrillator inserted for nonischemic cardiomyopathy. Shortly after arrival, she developed sustained ventricular tachycardia, causing repetitive unsuccessful ICD shocks. She was intubated and ventricular tachycardia resolved with amiodarone. Chest radiograph revealed large left sided tension pneumothorax which was promptly drained. The patient was treated for congestive heart failure; she was extubated on the third day of admission, and the chest tube was removed. Conclusion. Prompt recognition of tension pneumothorax is essential, by maintaining a high index of suspicion in patients with an increased defibrillation threshold causing ineffective defibrillations.

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Device Therapy of Rhythm Disorders

2017

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Loss of Left Ventricular Epicardial Lead Capture Due to Pneumothorax

Abstract: Pneumothorax is a rare complication of pacemaker lead insertion by subclavian way. We report a case of temporary ineffective biventricular pacing due to pneumothorax. This complication has to be ruled out before electing to reposition or to replace the lead.

Cited by 3 publications

References 3 publications

Intermittent Epicardial Lead Failure Detected Using a Continuous Ambulatory Electrocardiogram Monitor

Intermittent Epicardial Lead Failure Detected Using a Continuous Ambulatory Electrocardiogram Monitor

Traumatic Tension Pneumothorax as a Cause of ICD Failure: A Case Report and Review of the Literature

Device Therapy of Rhythm Disorders

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