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Case Reports
. 2022 Jun 22;4(14):857-861.
doi: 10.1016/j.jaccas.2022.05.014. eCollection 2022 Jul 20.

Cardiac Strangulation in Children: Asymptomatic Complication of Epicardial Pacing

Olga Yu Dzhaffarova  1 , Liliya I Svintsova  1 , Elena O Kartofeleva  1 , Sergey N Krivolapov  1 , Evgeny A Svyazov  1 , Irina V Plotnikova  1 , Sergey V Popov  1
Affiliations
Case Reports

Cardiac Strangulation in Children: Asymptomatic Complication of Epicardial Pacing

Olga Yu Dzhaffarova et al. JACC Case Rep. .

Abstract

Cardiac strangulation is a rare but potentially life-threatening mechanical complication associated with epicardial pacemaker implantation in growing children. This article presents 2 case reports of left ventricular strangulation in 4- and 3-year-old children who had an epicardial pacemaker system implanted at an early age. (Level of Difficulty: Advanced.).

Keywords: CHB, complete heart block; CS, cardiac strangulation; DDDR, dual chamber rate adaptive pacing mode; ECG, electrocardiogram; LV, left ventricle; RA, right atrium; cardiac pacing; complication; pediatric surgery.

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Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
First Patient (A) Echocardiography: left ventricle (LV) geometry is damaged (“hourglass head”). (B) Lateral view of the x-ray. The pacemaker lead was completely wrapped around the cardiac silhouette. (C) Left ventriculography showing deformation of LV contour in the apex view. (D) Lateral view of the postoperative x-ray showing the leads well placed at the bottom of the pericardium. LA = left atrium.
Figure 2
Figure 2
Electrocardiogram (A) The first case. (B) The second case. Pacing in DDD mode. P = synchronized ventricular pacing.
Figure 3
Figure 3
Strangulation Groove From the Loop of the Atrial Epicardial Lead LV = left ventricle; SG = strangulation groove.
Figure 4
Figure 4
Second Patient (A) Frontal view of the x-ray. (B) Lateral view of the c-ray confirming the diagnosis of cardiac strangulation showing a classic pattern of looping. (C) Computed tomography with intravenous bolus contrast confirming a loop around the heart; the conflicts with heart structures and vessels were not detected. The frontal view shows the epicardial leads looping left ventricle. (D) The lateral view shows the leads looping left ventricle.
See this image and copyright information in PMC

References

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