Why the study?
Coronary artery compression or damage by cardiac pacing or defibrillation leads is very rare and often an unknown complication of pacemaker implantation.
Highlights the rare complication of LAD compression by an endocardial defibrillator lead, suggesting caution in lead extraction when such compression is discovered.
Retaining malfunctioning leads with asymptomatic LAD compression may be prudent; leaves open true incidence and management implications.
Coronary artery compression/damage by cardiac pacing/defibrillation leads is very rare and often an unknown complication of pacemaker implantation. Here, we present the case of a 71-year-old woman with late discovery of an asymptomatic compression of the left anterior descending (LAD) coronary artery by a defibrillation lead implanted ten years before. This dissuaded us in removing this now malfunctioning lead with high threshold, and an additional right ventricular (RV) lead was implanted along with atrial and left ventricular (LV) leads for allowing resynchronization therapy. Based on the published data, a majority of RV leads are currently implanted in the "anteroseptal area," which is neighboring the course of the LAD.
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Scripcariu et al. (2023) studied this question.
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