Dual Chamber Pacemaker Implant in Coronary Sinus Leading to Several Complications

Permanent pacemaker implantation is a low-risk procedure. However, complications may occur at a rate of around 4–8%. We present a case where initial implantation resulted in complications that could have been avoided by meticulous assessment of lead position in different projections and early post-p...

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Main Authors: Nancy Wassef, Mina Ibrahim, Christine Botrous, Amr Anos, Kai Hogrefe, Janaka Pathiraja
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/22/2465
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author Nancy Wassef
Mina Ibrahim
Christine Botrous
Amr Anos
Kai Hogrefe
Janaka Pathiraja
author_facet Nancy Wassef
Mina Ibrahim
Christine Botrous
Amr Anos
Kai Hogrefe
Janaka Pathiraja
author_sort Nancy Wassef
collection DOAJ
description Permanent pacemaker implantation is a low-risk procedure. However, complications may occur at a rate of around 4–8%. We present a case where initial implantation resulted in complications that could have been avoided by meticulous assessment of lead position in different projections and early post-procedure X-ray that would have delineated other serious complications. We present a case where the right ventricular lead was placed in the coronary sinus, which resulted in the loss of pacing capture with further syncope after the pacemaker implant. This was apparent in the post-procedure electrocardiogram (ECG) with right bundle branch pacing and the lead was repositioned in the right ventricular apex the following day. Furthermore, the patient was discharged home without a chest X-ray (CXR), and she represented a week later with a haemo-pneumothorax and pericardial effusion. A chest drain was placed and was discharged after a slow recovery following several complications that could have been avoidable.
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series Diagnostics
spelling doaj-art-d606d7981cbd41228a9d35bbc4fd12e72025-08-20T02:28:04ZengMDPI AGDiagnostics2075-44182024-11-011422246510.3390/diagnostics14222465Dual Chamber Pacemaker Implant in Coronary Sinus Leading to Several ComplicationsNancy Wassef0Mina Ibrahim1Christine Botrous2Amr Anos3Kai Hogrefe4Janaka Pathiraja5Gloucestershire Hospitals Foundation Trust, Cheltenham General Hospital, Sandford Road, Cheltenham GL53 7AN, UKBristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, UKGloucestershire Hospitals Foundation Trust, Cheltenham General Hospital, Sandford Road, Cheltenham GL53 7AN, UKGloucestershire Hospitals Foundation Trust, Cheltenham General Hospital, Sandford Road, Cheltenham GL53 7AN, UKKettering General Hospitals, Rothwell Road, Kettering NN16 8UZ, UKGloucestershire Hospitals Foundation Trust, Cheltenham General Hospital, Sandford Road, Cheltenham GL53 7AN, UKPermanent pacemaker implantation is a low-risk procedure. However, complications may occur at a rate of around 4–8%. We present a case where initial implantation resulted in complications that could have been avoided by meticulous assessment of lead position in different projections and early post-procedure X-ray that would have delineated other serious complications. We present a case where the right ventricular lead was placed in the coronary sinus, which resulted in the loss of pacing capture with further syncope after the pacemaker implant. This was apparent in the post-procedure electrocardiogram (ECG) with right bundle branch pacing and the lead was repositioned in the right ventricular apex the following day. Furthermore, the patient was discharged home without a chest X-ray (CXR), and she represented a week later with a haemo-pneumothorax and pericardial effusion. A chest drain was placed and was discharged after a slow recovery following several complications that could have been avoidable.https://www.mdpi.com/2075-4418/14/22/2465heart blockpermanent pacemakercomplicationslearning points
spellingShingle Nancy Wassef
Mina Ibrahim
Christine Botrous
Amr Anos
Kai Hogrefe
Janaka Pathiraja
Dual Chamber Pacemaker Implant in Coronary Sinus Leading to Several Complications
Diagnostics
heart block
permanent pacemaker
complications
learning points
title Dual Chamber Pacemaker Implant in Coronary Sinus Leading to Several Complications
title_full Dual Chamber Pacemaker Implant in Coronary Sinus Leading to Several Complications
title_fullStr Dual Chamber Pacemaker Implant in Coronary Sinus Leading to Several Complications
title_full_unstemmed Dual Chamber Pacemaker Implant in Coronary Sinus Leading to Several Complications
title_short Dual Chamber Pacemaker Implant in Coronary Sinus Leading to Several Complications
title_sort dual chamber pacemaker implant in coronary sinus leading to several complications
topic heart block
permanent pacemaker
complications
learning points
url https://www.mdpi.com/2075-4418/14/22/2465
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AT christinebotrous dualchamberpacemakerimplantincoronarysinusleadingtoseveralcomplications
AT amranos dualchamberpacemakerimplantincoronarysinusleadingtoseveralcomplications
AT kaihogrefe dualchamberpacemakerimplantincoronarysinusleadingtoseveralcomplications
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