Abandoned Intracardiac Electrodes in an Oncological Patient.
Aneta KlotzkaSylwia IwańczykKarolina SobańskaPrzemysław MitkowskiPatrycja WoźniakMaciej LesiakPublished in: Journal of personalized medicine (2023)
Cardiological and oncological patients comprise the majority of patients admitted to the emergency unit with chronic or acute conditions that are the dominant cause of death worldwide. However, electrotherapy and implantable devices (pacemakers and cardioverters) improve the prognosis of cardiological patients. We present the case report of a patient who, in the past, had a pacemaker implanted due to symptomatic sick sinus syndrome (SSS) without removing the two remaining leads. Echocardiography revealed severe tricuspid valve regurgitation. The tricuspid valve septal cusp was in a restricting position due to the two ventricular leads passing through the valve. A few years later, she was diagnosed with breast cancer. We present a 65-year-old female admitted to the department due to right ventricular failure. The patient manifested symptoms of right heart failure, predominated by ascites and lower extremity edema, despite increasing doses of diuretics. The patient underwent a mastectomy two years ago due to breast cancer and was qualified for thorax radiotherapy. A new pacemaker system was implanted in the right subclavian area as the pacemaker generator occupied the radiotherapy field. In the case of right ventricular lead removal and the need for pacing and resynchronization therapy, guidelines allow a coronary sinus for LV pacing to avoid passing the leads through the tricuspid valve. We facilitated this approach in our patient, suggesting that the percentage of ventricular pacing was very low.
Keyphrases
- case report
- aortic stenosis
- aortic valve
- ejection fraction
- mitral valve
- heart failure
- left ventricular
- transcatheter aortic valve replacement
- cardiac resynchronization therapy
- early stage
- radiation therapy
- public health
- healthcare
- prognostic factors
- emergency department
- prostate cancer
- coronary artery disease
- coronary artery
- liver failure
- radiation induced
- rectal cancer
- locally advanced
- mesenchymal stem cells
- vena cava
- pulmonary embolism
- early onset
- hepatitis b virus
- tertiary care
- respiratory failure
- inferior vena cava
- smoking cessation
- aortic dissection
- acute respiratory distress syndrome