Fluoroscopy should be used during removal of a temporary lead to avoid dislodgment of a newly implanted permanent pacemaker lead.
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Complication during temporary lead removal in presence of permanent lead calls for procedural caution; hypothesis-generating regarding routine fluoroscopy.
A 63-year-old male received a transvenous temporary pacemaker for bradyarrhythmia following mitral valve replacement and tricuspid valve annuloplasty. A transvenous permanent pacemaker was implanted the following day due to persistence of the bradyarrythmia and pacemaker dependency of the patient. Later the same day during removal of the temporary pacing electrode the permanent pacing lead was dislodged and had to be operatively repositioned. To avoid this complication, the position of pacemaker leads should be checked postoperatively with a frontal and lateral chest radiograph, and fluoroscopy should be used during removal of a temporary lead.
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Jaeger et al. (1994) studied this question.
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