Key result
Implantation of a dual chamber ICD using an active-fixation atrial lead resulted in chronic severe pericarditis due to mechanical stimulus from the lead screw.
Case Report (n=1)
Active-fixation atrial leads can cause delayed chronic severe pericarditis due to mechanical stimulation of the pericardium by the screw.
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Raises caution with active-fixation atrial leads; case report leaves open incidence and prevention strategies.
A 57-year-old man with nonischemic dilated cardiomyopathy and ventricular tachycardia underwent routine dual chamber implantable cardioverter defibrillator (ICD) implantation. An active-fixation atrial lead was positioned at the lateral wall of the right atrium. He subsequently developed chronic severe pericarditis. Histopathological findings of the pericardium showed mechanical stimulus localized pericarditis. This case demonstrates that contact of the screw of the active-fixation atrial lead with the pericardium may be a possible mechanism for pericarditis after pacemaker/ICD implantation.
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Kono et al. (2008) conducted a case report in Nonischemic dilated cardiomyopathy and ventricular tachycardia (n=1). Implantable cardioverter defibrillator (ICD) implantation with an active-fixation atrial lead was evaluated on Chronic severe pericarditis. Implantation of a dual chamber ICD using an active-fixation atrial lead resulted in chronic severe pericarditis due to mechanical stimulus from the lead screw.
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