Author + information
- Olga Reynbakh,
- Nader Ishak Gabra,
- Allen Weiss,
- Shawn Lee,
- Steven Hobson,
- Mariam Khandaker,
- Robert Kornberg and
- Emad Aziz
Background: Migration of epicardial leads is a rare complication, previously described cases illustrate leads perforating myocardium and dislodging into RV outflow tract or pulmonary artery. We are describing a case of a dislodged lead that travelled outside of the heart and migrated to the spine causing an abscess.
Case: Patient is a 63 year old Male with medical history of HFrEF, Bi-ventricular ICD with epicardial lead placement in 2005, aortic dissection with aortic grafts and mechanical aortic valve replacement, aortic arch revision, ICD generator exchange complicated by endocarditis with lead explantation, ICD pocket Serratia infection. Patient presented with 2 days of fever, chills and back pain, he was found to be in septic shock. His condition was stabilized with hemodynamic support, vasopressors, initiation of broad spectrum IV antibiotics. CT spine revealed dislodged epicadial lead entering T9 and causing vertebral abscess. Cardiothoracic surgery was consulted and decision was made to perform Video-assisted thoracoscopic surgery with removal of the migrated epicardial lead and drainage of the abscess.
Discussion: This is unusual case of epicardial lead displacement into the vertebra with development of an abscess. It demonstrates the necessity to have a high suspicion of lead complications such as migration outside of the heart when patient with history of multiple ICD complications as well as open heart surgeries presents with fever and requires thorough evaluation with imaging methods.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias and Clinical EP: Devices 3
Abstract Category: 5. Arrhythmias and Clinical EP: Devices
Presentation Number: 1188-080
- 2017 American College of Cardiology Foundation