This case demonstrates that friction between intracardiac leads can cause early abrasion of silicone insulation, potentially leading to infective endocarditis.
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Raises caution for insulation integrity in multi-lead CIED patients; case report leaves open implications for lead selection and monitoring.
We present a case of a 76-year-old woman on a permanent pacing device, with early abrasion of silicone endocardial lead insulations complicated by lead-dependent infective endocarditis 13 months after placement of an implantable pulse generator. The leads were removed using transvenous technique with direct traction, and with no additional tools. In the previous report, a set of additional tools was used, and therefore intraoperative endocardial lead abrasions or mechanical damage of leads could have not been excluded. The present case undoubtedly proves that the friction of leads against each other may result in abrasions of insulation of the intracardiac section of the lead.
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Ząbek et al. (2010) studied this question.
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