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Case Reports
. 2020 Jan 22;8(2):383-386.
doi: 10.1002/ccr3.2669. eCollection 2020 Feb.

Fracture of an epicardial left ventricular lead implanted at open-heart surgery in anticipation of future need for cardiac resynchronization therapy

Jacob Moesgaard Larsen  1   2 , Jamil Bashir  3 , Zachary William Laksman  1
Affiliations
Case Reports

Fracture of an epicardial left ventricular lead implanted at open-heart surgery in anticipation of future need for cardiac resynchronization therapy

Jacob Moesgaard Larsen et al. Clin Case Rep. .

Abstract

Epicardial left ventricular leads can be implanted at open-heart surgery for cardiac resynchronization therapy. We report a 2-year-old fractured epicardial left ventricular lead detected at generator implant. It highlights the importance of good surgical implant technique and of rigorous lead evaluation for signs of impending failure at generator implant.

Keywords: cardiac resynchronization therapy; epicardial lead; lead failure; open‐heart surgery.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Postoperative chest X‐ray after open‐heart surgery in 2016 with aortic root replacement using a valve conduit and concomitant implant of a bipolar epicardial left ventricular lead with the silicone covered header placed in the subcutaneous tissue in the left pectoral area. No signs of damage to the epicardial lead at implant
Figure 2
Figure 2
Intraprocedure photo from the cardiac resynchronization therapy device implant in 2018 showing the proximal explanted fragment of the fractured epicardial lead
Figure 3
Figure 3
Focused postprocedure chest x‐ray after the cardiac resynchronization therapy device implant in 2018 with three transvenous leads in the right atrium, right ventricle, and left ventricle via the coronary sinus, respectively. The abandoned part of the epicardial left ventricular lead was completely fractured at the suprasternal notch (superior arrow) with an isolated short extrathoracic subcutaneous fragment that also was severed from the explanted part of the lead at the level of one of the fractured sternal wires (inferior arrow)
See this image and copyright information in PMC

References

    1. Cleland JGF, Daubert J‐C, Erdmann E, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005;352:1539‐1549. - PubMed
    1. Moss AJ, Hall WJ, Cannom DS, et al. Cardiac‐resynchronization therapy for the prevention of heart‐failure events. N Engl J Med. 2009;361:1329‐1338. - PubMed
    1. Rickard J, Johnston DR, Price J, et al. Reverse ventricular remodeling and long‐term survival in patients undergoing cardiac resynchronization with surgically versus percutaneously placed left ventricular pacing leads. Hear Rhythm. 2015;12:517‐523. - PubMed
    1. Chen L, Fu H, Pretorius VG, et al. Clinical outcomes of cardiac resynchronization with epicardial left ventricular lead. Pacing Clin Electrophysiol. 2015;38:1201‐1209. - PubMed
    1. van Dijk VF, Fanggiday J, Balt JC, et al. Effects of epicardial versus transvenous left ventricular lead placement on left ventricular function and cardiac perfusion in cardiac resynchronization therapy: A randomized clinical trial. J Cardiovasc Electrophysiol. 2017;28:917‐923. - PubMed

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