Key result
A 94-year-old man experienced intra-abdominal migration of an active-fixation right ventricular pacemaker lead 13 days post-implantation, successfully managed by simple traction removal.
Case Report (n=1)
Active-fixation pacemaker leads placed in the free wall apical position in elderly patients can migrate into the abdominal cavity, but may be safely removed by simple traction.
Alerts clinicians to rare early lead migration despite active fixation in elderly; leaves open optimal prevention strategies.
A 94-year-old man with symptomatic third-degree atrioventricular (AV) block was implanted a single-chamber pacemaker with active-fixation lead without complications. Thirteen days later, he was admitted with bradycardia symptoms. Total AV block was documented with absence of capture at any voltage. Chest X-ray and thoracic computed tomography showed dislocation of the lead towards the abdominal cavity without pericardial effusion and no colon perforation. Lead removal by simple traction and a new lead implantation was performed uneventfully, instead of surgical lead extraction with backup for emergency thoracotomy. Lead type and free wall apical position in a nonagenarian patient contributed to perforation. Conflict of interest: none declared.
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Elices‐Teja et al. (2020) conducted a case report in Symptomatic third-degree atrioventricular block (n=1). Single-chamber pacemaker with active-fixation lead was evaluated on Lead dislocation/migration. A 94-year-old man experienced intra-abdominal migration of an active-fixation right ventricular pacemaker lead 13 days post-implantation, successfully managed by simple traction removal.
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