DSA Diagnosis of Pulmonary Embolization from Intracardial Thrombus in a Patient with Permanent Pacing Catheter

Abstract

Pulmonary embolization in patients with implanted pacemakers is rare and an intracardiac thrombus attached to the distal end of a newly implanted ventricular endocardial electrode following removal of a previously implanted lead is a curiosity. We have documented such a case by digital subtraction angiography, a minimally invasive procedure that demonstrates both an intracardiac thrombus and secondary pulmonary embolization in a single procedure, which also allows simplified follow-up evaluation following therapy.

Long-Term outcomes of cardiac pacing in adults with congenital heart disease

“…Although echocardiography would have been performed routinely in follow-up, it is certainly feasible that the incidence of thrombus has been underestimated. Thrombus on transvenous pacing leads in adults with acquired heart disease is an established complication of pacing (17). It is likely that CHD patients in whom enlarged atria and low-velocity flow states are frequently encountered (18) are at increased risk for such thrombus.…”

Relationship between changes in selected thrombotic and inflammatory factors, echocardiographic parameters and the incidence of venous thrombosis after pacemaker implantation based on our own observations

“…Major complications of pacemaker implantation include venous occlusion [1], thrombus formation in cardiac cavity [2, 3], superior vena cava syndrome [4, 5], recurrent venous thrombotic events and post-thrombotic syndrome [6]. Symptoms of thrombosis occur in about 0.5-5% and life-threatening blood clots in 0.6-3.5% of all pacemaker implantation cases [6].…”