Early displacement of an atrial lead: A fatal presentation of a relatively frequent complication

Gala Caixal; Victor Garcia-Hernando; Jordi Punti; Maria Soledad Ascoeta-Ortiz; Gabriel Gusi; Antonio Martinez-Rubio

doi:10.24207/jca.v38i1.3561

Authors

Gala Caixal Parc Taulí Hospital Universitari – Cardiology Department – Arrhythmia Unit – Sabadell, Barcelona, Spain | Universitat Autònoma de Barcelona – Departament of Medicine – Barcelona, Spain. https://orcid.org/0000-0003-1830-3125
Victor Garcia-Hernando Parc Taulí Hospital Universitari – Cardiology Department – Arrhythmia Unit – Sabadell, Barcelona, Spain | Universitat Autònoma de Barcelona – Departament of Medicine – Barcelona, Spain. https://orcid.org/0000-0003-1190-6679
Jordi Punti Parc Taulí Hospital Universitari – Cardiology Department – Arrhythmia Unit – Sabadell, Barcelona, Spain | Universitat Autònoma de Barcelona – Departament of Medicine – Barcelona, Spain. https://orcid.org/0009-0002-1880-1706
Maria Soledad Ascoeta-Ortiz Parc Taulí Hospital Universitari – Cardiology Department – Arrhythmia Unit – Sabadell, Barcelona, Spain | Universitat Autònoma de Barcelona – Departament of Medicine – Barcelona, Spain. https://orcid.org/0000-0002-9455-5861
Gabriel Gusi Parc Taulí Hospital Universitari – Cardiology Department – Arrhythmia Unit – Sabadell, Barcelona, Spain | Universitat Autònoma de Barcelona – Departament of Medicine – Barcelona, Spain. https://orcid.org/0009-0006-9416-949X
Antonio Martinez-Rubio Parc Taulí Hospital Universitari – Cardiology Department – Arrhythmia Unit – Sabadell, Barcelona, Spain | Universitat Autònoma de Barcelona – Departament of Medicine – Barcelona, Spain. https://orcid.org/0000-0002-2070-4617

DOI:

https://doi.org/10.24207/jca.v38i1.3561

Keywords:

Dual chamber pacemaker, Atrial lead displacement, Ventricular arrythmia, Sudden cardiac death

Abstract

An 81-year-old woman was referred to Parc Taulí Hospital Universitari with complete atrioventricular block and a dual-chamber pacemaker was implanted. She subsequently presented an episode of ventricular tachycardia that degenerated into ventricular fibrillation requiring cardiopulmonary resuscitation. After review of the device, as well as the electrocardiogram and chest X-ray, displacement of the atrial lead into the right ventricle was confirmed. Contrary to expectations, the ventricular event was not secondary to endocardial irritation by the displaced lead, so the hypothesis of a possible depolarization-repolarization heterogeneity as a cause of the increased arrhythmogenicity was raised.

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References

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