Recurrent cardioembolic stroke related to late dislodgment of a right atrial pacing lead into the left atrium

Perforation of a cardiac chamber is an infrequent but serious sequela of pacemaker lead implantation. An even rarer event is the perforation of the aorta by a protruding right atrial wire. We present here the first case in the medical literature of aortic perforation as a sequela to the implantation of a cardiac resynchronization therapy defibrillator. The patient was a 54-year-old man with idiopathic dilated cardiomyopathy who underwent the implantation of a defibrillator, with no apparent sequelae. Six hours after the procedure, he experienced cardiac tamponade and required urgent open-chest surgery. The pericardial effusion was found to be caused by mechanical friction of a protruding right atrial wire on the aortic root. The aortic root and the atrial wall were both repaired with Prolene suture, which achieved complete control of the bleeding. There was no need to reposition the atrial wire. The patient had a good postoperative recovery.

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Autonomic Neural Remodeling of the Pulmonary Vein-Left Atrium Junction in a Prolonged Right Atrial Pacing Canine Model

Pacing and Clinical Electrophysiology ◽

10.1111/pace.12338 ◽

2013 ◽

Vol 37 (6) ◽

pp. 745-750 ◽

Cited By ~ 11

Author(s):

SHAOHUA ZHENG ◽

YUJIAO ZHANG ◽

ZHONGSU WANG ◽

ZHIYUAN LI ◽

XUJUAN HOU ◽

...

Keyword(s):

Left Atrium ◽

Pulmonary Vein ◽

Canine Model ◽

Right Atrial ◽

Atrial Pacing ◽

Neural Remodeling

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857 Efficacy of right atrial pacing preference in the prevention of paroxysmal atrial fibrillation: atrial pacing preference study (APP study)

EP Europace ◽

10.1016/s1099-5129(05)80614-2 ◽

2005 ◽

Vol 7 ◽

pp. 209-209

Keyword(s):

Atrial Fibrillation ◽

Paroxysmal Atrial Fibrillation ◽

Right Atrial ◽

Atrial Pacing ◽

Preference Study

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Serial fluoroscopic evaluation of the telectronics accufix™ 330–801 “J” shaped atrial pacing lead

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(96)82288-1 ◽

1996 ◽

Vol 27 (2) ◽

pp. 345

Author(s):

Margaret A. Lloyd ◽

David L. Hayes ◽

David R. Holmes

Keyword(s):

Atrial Pacing ◽

Pacing Lead

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Elevated plasma endothelin-1 levels in coronary sinus during rapid right atrial pacing in patients with slow coronary flow

International Journal of Cardiology ◽

10.1016/j.ijcard.2003.06.025 ◽

2004 ◽

Vol 97 (1) ◽

pp. 35-41 ◽

Cited By ~ 39

Author(s):

Hasan Pekdemir ◽

Gurbuz Polat ◽

V.Gökhan Cin ◽

Ahmet Çamsari ◽

Dilek Cicek ◽

...

Keyword(s):

Coronary Sinus ◽

Coronary Flow ◽

Right Atrial ◽

Atrial Pacing ◽

Elevated Plasma ◽

Slow Coronary Flow ◽

Endothelin 1

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A rare and independent association of Right Atrial Myxoma with Immune Thrombocytopenic Purpura

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20192935 ◽

2019 ◽

Vol 7 (7) ◽

pp. 2856

Author(s):

Karthik Raman R. ◽

Vijay Anand Palanisamy ◽

Mithun Sundararaja Ravikumar ◽

Jeswin Moses ◽

Sivakumar Pandian ◽

...

Keyword(s):

Left Atrium ◽

Clinical Features ◽

Immune Thrombocytopenic Purpura ◽

Atrial Myxoma ◽

Right Atrial ◽

Thrombocytopenic Purpura ◽

Presenting Symptoms ◽

Right Atrial Myxoma ◽

Independent Association

Primary tumours of the heart are rare and the most common benign ones are myxomas. The clinical features are varied and include a myriad of presenting symptoms like embolic, constitutional, cardiac and also symptoms due to obstruction. Right atrial myxomas are very rarely seen when compared with left atrium. Such myxomas independently co existing with Immune Thrombocytopenic Purpura (ITP) is even rarer and we now present one such case in with right atrial myxoma was associated with ITP and was managed surgically. This case emphasises the fact that ITP can co-exist with myxoma and should be borne in mind when treating such patients surgically.

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Feasibility and efficacy using the KODEX-EPD imaging system in right atrial flutter ablation: a single center experience

European Heart Journal ◽

10.1093/eurheartj/ehab724.0383 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

V Schillaci ◽

G Stabile ◽

G Shopova ◽

A Arestia ◽

A Agresta ◽

...

Keyword(s):

Atrial Flutter ◽

Imaging System ◽

Conduction Block ◽

Right Atrial ◽

Atrial Pacing ◽

Funding Sources ◽

Single Center Experience ◽

Typical Atrial Flutter ◽

Procedural Time

Abstract Background Isthmus-dependent right atrial flutter is the most frequently encountered atrial flutter in clinical practice (80–90% of atrial flutters). Purpose The aim of our study was to assess as first experience the feasibility and safety of radiofrequency catheter ablation (RFCA) of cavo-tricuspid isthmus (CTI) guided by KODEX-EPD imaging system in patients presenting with typical atrial flutter (AFL). Methods 16 consecutive patients (mean age 68,46±7,8 years, 80% males) with diagnosis of AFL underwent RFCA guided by KODEX-EPD imaging system. In 15 patients the analysis performed during tachycardia showed a counter-clockwise activation. In 1 patient no tachycardia could be induced and the ablation was performed in sinus rhythm with fixed pacing from the coronary sinus. The KODEX-EPD imaging system was also used to guide ablation and to confirm persistent bidirectional block after ablation. Results Mean procedural time was 37,6±8,2 min, mean radiofrequency ablation time was 7,8±3,4 min, and mean fluoroscopy time was 2,1±1,2 min. All procedures were acutely successful with interruption of AFL during RFCA along the inferior CTI in 15 patients and achievement of the bidirectional conduction block in 16 patients proven by atrial pacing medial and lateral to the ablation line. There were no major procedural and 30-day complications. Over a mean follow-up of 18 months, we observed no recurrence of arrhythmia and no complications. Conclusions Our study shows that RFCA for AFL using the KODEX-EPD imaging system is feasible, safe, and effective. FUNDunding Acknowledgement Type of funding sources: None.

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