Key result
Diagnostic work-up of a malfunctioning ICD lead in a 21-year-old male revealed long-segment transmural migration, leading to the decision to leave the lead in situ to avoid vein perforation.
Case Report (n=1)
No
Transmural migration of ICD leads can occur in patients implanted during childhood due to growth-related tension, making lead extraction potentially hazardous and favoring leaving the lead in situ.
Answers are grounded in this paper and cite their sources.
Caution against extraction in suspected transmural migration of pediatric ICD leads; leaves open need for prospective management data.
The need for pacemaker and implantable cardioverter defibrillator (ICD) lead revisions and extractions is steadily increasing. Despite the lack of representative studies, the risk of lead extraction is frequently considered to be lower than leaving nonfunctional leads in situ. We report the case of a patient who was referred to our institution for exchange of a malfunctioning ICD lead. The diagnostic work-up revealed a long-segment transmural migration of the ICD lead at the site of the subclavian and innominate vein. Due to the unpredictable risk of vein perforation, we abandoned the extraction procedure.
No takes yet. Share an insight, caveat, or question.
Brodoefel et al. (2015) conducted a case report in Brugada syndrome with malfunctioning ICD lead (n=1). Leaving malfunctioning ICD lead in situ was evaluated on Procedural success and safety. Diagnostic work-up of a malfunctioning ICD lead in a 21-year-old male revealed long-segment transmural migration, leading to the decision to leave the lead in situ to avoid vein perforation.
Synapse has enriched 10 related papers. Consider them for comparative context: