Thrombus formation at the tip of a leadless pacemaker causing multiple unnecessary repositioning

Arias, Miguel Á.; Rubio, Miguel A.; Miguel, Ramón de; Pachón, Marta

doi:10.1016/j.hrthm.2016.07.006

Cited by 9 publications

(8 citation statements)

References 1 publication

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“…While in our case, there was a complication related to a thrombus formation, leading to device impedance issues; this complication has previously been reported, and in our case, there were no complications directly related to the presence of the IVC filter.…”

Section: Discussionsupporting

confidence: 53%

“…On postoperative day 1, the device interrogation revealed a dramatically increased impedance from 440 Ohms to nearly 2,500 Ohms. This was felt to be related to a small blood clot in between the leadless pacemaker and the myocardial tissue . Given the patient's frail condition, the decision was made to monitor his pacing parameters closely, rather than revise the indwelling pacemaker.…”

Section: Case Reportmentioning

confidence: 99%

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Successful implantation of a leadless pacemaker in a patient with an IVC filter

Franzil

Rytlewski

2017

Pacing Clinical Electrophis

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Section: Discussionsupporting

confidence: 53%

Section: Case Reportmentioning

confidence: 99%

Successful implantation of a leadless pacemaker in a patient with an IVC filter

Franzil

Rytlewski

2017

Pacing Clinical Electrophis

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“…Moreover, clot formation inside the delivery system has recently been reported in association with a case of indissoluble knot formation. Adequate heparinized saline flow rate was recommended by the authors . In our case, high flow rate of heparinized saline did not prevent knot and clot formation.…”

Section: Discussionmentioning

confidence: 60%

Troubleshooting in PM Leadless: How to manage an indissoluble knot

Morani

Bolzan

Tomasi

et al. 2019

Journal of Arrhythmia

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A 77‐year‐old patient, with permanent atrial fibrillation, underwent successful Micra transcatheter pacing system (MTPS) implantation. Once begun the pull‐back of the tether, an increasing resistance was felt by the operator until complete blockage. A challenging recapture of MTPS into the delivery system was performed. The retrieved MTPS showed an indissoluble knot close to the docking button that blocked the running of the tether, and a long clot inside the delivery system. The new design of internal handle components of MTPS recently updated seems to favor clot formation. We suggest a reconsideration of the standard recommendations about delivery system flushing and design of the inner flushing tube system.

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“…Washing the delivery system with heparinised saline at a velocity of 100–300 mL/hour is recommended to avoid thrombus formation. 11 However, this complication might not have been prevented by heparin infusion or heparinised saline flushes. Therefore, the transvenous approach may be a better choice for pacemaker implantation following blood transfusion.…”

Section: Discussionmentioning

confidence: 99%

Difficulty removing a leadless pacemaker in a post-transfusion patient

et al. 2021

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A 99-year-old woman with atrial fibrillation bradycardia and symptomatic long pauses underwent a leadless pacemaker implantation after red blood cell transfusion due to anaemia. The patient’s blood tests after transfusion showed hypercoagulability; haematocrit, haemoglobin and fibrinogen levels were increased from 24.5% to 33.2%, 76 g/L to 111g/L, and 346 mg/dL to 646 mg/dL, respectively. Blood tests showed no hereditary hypercoagulability disorder and she had no history of thrombophilia. A leadless pacemaker was implanted in the correct position in the right ventricle. Heparin was administered after sheath insertion and the leadless pacemaker system was thoroughly flushed with heparinised saline before the tether was cut; however, removing the tether after leadless pacemaker implantation was difficult because clots had formed on the tether.

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Thrombus formation at the tip of a leadless pacemaker causing multiple unnecessary repositioning

Cited by 9 publications

References 1 publication

Successful implantation of a leadless pacemaker in a patient with an IVC filter

Successful implantation of a leadless pacemaker in a patient with an IVC filter

Troubleshooting in PM Leadless: How to manage an indissoluble knot

Difficulty removing a leadless pacemaker in a post-transfusion patient

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