Acute transvenous pacemaker lead thrombosis early after implantation: A rare clinical scenario

Pacing Clin Electrophysiol. 2023 Aug;46(8):934-938. doi: 10.1111/pace.14647. Epub 2023 Jan 10.

Abstract

Symptomatic thrombus formation due to a permanent pacemaker (PM) lead is a rare complication. It could be associated with serious outcome and should be suspected in patients who present with unexplained right heart failure, dyspnea, or syncope following dual-chamber PM implantation. A timely decision to perform an echocardiographic examination, followed by medical, thrombolytic, or surgical treatment can be necessary. We describe the case of an 84-year-old man who presented with syncope and hypotension a few days after PM implantation. A transesophageal echocardiography revealed a mobile mass in the right atrium attached to the pacemaker lead. Intravenous heparin allowed a complete resolution of the thrombus.

Keywords: acute thrombosis; early thrombosis; pacing; pulmonary embolism; right atrium mass; right ventricular pacemaker lead.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Echocardiography
  • Echocardiography, Transesophageal
  • Humans
  • Male
  • Pacemaker, Artificial* / adverse effects
  • Syncope
  • Thrombosis* / diagnostic imaging
  • Thrombosis* / etiology