Key result
Retained epicardial pacemaker leads can trigger severe delayed pulmonary abscess requiring surgical lobectomy.
Why the study?
Epicardial pacemaker leads are used when transvenous access is contraindicated, but retained leads can rarely result in serious long-term complications.
Case Report (n=1)
Retained permanent epicardial pacing leads are not biologically inert and can migrate to cause severe delayed infectious complications, such as lung abscesses.
Answers are grounded in this paper and cite their sources.
Retained epicardial leads may rarely cause delayed abscess; this case leaves open optimal extraction and surveillance strategies.
BACKGROUND: Epicardial pacemaker leads are used when transvenous access is contraindicated, but retained leads can rarely result in serious long-term complications. CASE SUMMARY: A 40-year-old male with intravenous drug use, tricuspid valve replacement, and prior epicardial pacemaker implantation presented with hemoptysis. Imaging revealed a left lower lobe lung abscess containing retained epicardial leads, left in situ after incomplete extraction years earlier. He underwent lobectomy and resection of infected leads. Postoperatively, he developed respiratory failure and arrhythmias requiring repeat epicardial pacemaker implantation, but ultimately recovered after rehabilitation. DISCUSSION: Lung abscess due to retained permanent epicardial leads is exceedingly rare. This case underscores diagnostic challenges, the morbidity of incomplete lead removal, and the importance of vigilance in patients with prior cardiac device history. TAKE-HOME MESSAGES: Retained permanent epicardial leads are not biologically inert and may predispose to severe infectious complications. Complete hardware extraction and long-term surveillance are critical.
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Bahar et al. (2025) conducted a case report in Lung abscess from retained epicardial pacing leads (n=1). Retained permanent epicardial pacemaker leads was evaluated. Retained permanent epicardial pacemaker leads can act as chronic foreign bodies predisposing patients to rare but severe delayed infectious complications such as pulmonary abscess requiring lobectomy.
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