Causes of pacemaker lead dislodgement

Congestive heart failure and implantation of right atrial (RA) lead at RA free wall or septum were significant factors for the incidence of lead dislodgement and lead revision. The …

Early displacements are more frequent than late displacements and they usually affect atrial leads. The incidence of early displacements is 1% in VVI pacemakers and 5.2% in DDD …2.1 Lead dislodgement Pacing lead displacement and dislodgement is a relatively common problem and can occur in 5-10 % of the patients (National Pacemaker and ICD database, 2001). Historically, the most common complication of transvenous pacing has been lead dislodgement. The leadsCT scan of the patient does not usually cause problems in the pacemakers. Therefore, the presence of an implanted pacemaker should not hinder such investigative imaging modality. In rare cases, it might …More than 1 million pacemakers and ≈400 000 implantable ... The RV apex has been the preferred site for RV lead placement because of the ease of implantation and low risk of lead dislodgement. 33 With the …This first article in a three-part series focuses on basics of the device and recognizing normal pacemaker rhythms on the ECG. Future articles will focus on identifying potentially serious pacemaker malfunctions. In this three-part series, we'll describe what you need to know about implanted pacemaker rhythms.26 Mar 2020 ... Twiddler's syndrome is a rare cause of pacemaker failure, where patient manipulation of the pulse generator results in lead dislodgement or ...Introduction and importance: Lead dislodgement syndromes (Twiddler, Ratchet or Reel syndromes) are rare causes of cardiac stimulation device malfunction that can occur most commonly early after device implantation. Each one of them associated with a unique pattern of lead coiling and dysfunction.

This first article in a three-part series focuses on basics of the device and recognizing normal pacemaker rhythms on the ECG. Future articles will focus on identifying potentially serious pacemaker malfunctions. In this three-part series, we'll describe what you need to know about implanted pacemaker rhythms.The most common acute cause just after the insertion procedure is lead dislodgement or malposition. In comparison, an increase in the required threshold promoting a loss of capture can happen ...Background: Pacemaker lead dislodgement may cause malfunction in the pacing system, which may lead to severe adverse events. For patients with sick sinus syndrome but normal atrioventricular conduction, atrial lead dislocation may cause excessive unnecessary ventricular pacing, resulting in nonphysiological pacing leading to heart failure. The... symptoms were gone and the sensing and pacing parameters went back ... In our report, we diagnosed two leads displacement and one lead perforation of pacemaker ...The pacemaker-twiddler’s syndrome is an uncommon cause of pacemaker malfunction. It occurs due to unintentional or deliberate manipulation of the pacemaker pulse generator within its skin pocket by the patient. This causes coiling of the lead and its dislodgement, resulting in failure of ventricular pacing. More commonly …A, Frontal chest radiograph shows Medtronic single-chamber pacemaker on right and CPI (Cardiac Pacemakers Incorporated) implantable cardioverter defibrillator (ICD) on left. Each device has different type of bipolar right ventricle (RV) lead. Tip electrodes are located at termination of both RV leads, whereas short proximal metallic …We report a case of inadvertent dislodgement of a permanent pacemaker lead after removal of a preoperatively placed venous sheath in a TAVI patient. Keywords: TAVI; …be much more unnoticed lead perforation or dislodgement even in the extremely late phase and pay extra attention to the relaxed shapes of atrial leads, especially in patients receiving immunosuppressive agents. Conclusions We report a case of atrial lead dislodgement 9 years after pacemaker implantation. Microperforation, lead instability,

Abstract. Objectives: This study sought to develop and evaluate an algorithm for early diagnosis of dislodged implantable cardioverter-defibrillator (ICD) leads. Background: Dislodged defibrillation leads may sense atrial and ventricular electrograms (EGMs), triggering shocks in the vulnerable period that induce ventricular fibrillation (VF).Discussion. Complications have been reported in up to 9% of atrial lead placements [].They are most often related to obtaining venous access (hemorrhage, pneumothorax: 2%) lead dislodgement (4.2%), inadequate pacing and sensing (3.5%) and acute pericarditis (5% in patients receiving active fixation atrial leads) [2,3].Subclavian …All leads are involved, at any time from implantation, and frequently damaged. In the past few years, a reel syndrome was also observed: retraction of pacemaker leads into pocket without patient manipulation, owing to lead circling the generator. In other cases, a ‘ratchet’ mechanism has been postulated.History. Clinical symptoms of pacemaker malfunction are variable and include syncope, dizziness, palpitations, and slow or fast heart rate. Extracardiac stimulation or hiccup may be present. Obtain as much information as possible regarding the pulse generator, leads, and programmed values. Information on time of initial device placement ...

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Specific adverse event rates included lead dislodgement (1%), hematoma (0.9%), pneumothorax (0.4%), and cardiac arrest (0.3%). Physician level of training and level of specialty certification have been shown to affect the risk of adverse events associated with ICD implant.The venous thrombosis associated with permanent pacemaker leads was first described a few years after the first endocardiac pacemakers were implanted. ... were not the cause of the fatal outcome of our patient. There are several useful imaging techniques for the diagnosis of pacing lead thrombosis in the right heart chambers. Transthoracic ...Pacemaker lead macrodislodgement is an unusual occurrence and is typically thought to be caused by Twiddler’s syndrome, 1 Reel syndrome, 2 or trauma to the pacemaker system, 3 all of which are mechanisms for lead dislodgement evolving from manipulation of the generator and/or lead. In this report, we postulate the cause of a transvenous ...Aug 4, 2022 · What is Known? Lead dislodgement (LD) is one of the most common complications of cardiovascular implantable electronic device implantation and has an incidence ranging from 1% to 8%. LDs occur more frequently in elderly patients with higher comorbidity burdens. In the prior studies with LBBP, although acute lead dislodgement and lead perforation within 24 hours of the implant were noted in about 3% of patients, late complications have not been reported during 3 to 6 months of follow-up. 4,5,6,8 The late occurrence of interventricular septal perforation seen in one of the patients is an …Pacing lead dislodgement contributes substantially, to the list of causes of early pacemaker failure. Reel's syndrome is a rare cause of pacemaker failure, resulting from the dislodging of pacing electrodes by manipulation of the pulse generator by the patient.

His second complication was the dislodgement of the RV pacemaker lead. The lead likely was dislodged by the rapid reversal of the mediastinal shift once the chest tube was placed. An alternative but less likely explanation is that the lead was pulled out gradually by the development of the mediastinal shift as his PTX was developing. Still, we ...Disengagement of a lead tip from connector header is the preventable cause of pacemaker malfunction. It occurs either due to loose set screw or screw tightening before proper lead placement in connector head. This complication is diagnosed by the increase in pacing threshold and an increase in lead impedance during pacemaker interrogation.The pacemaker-twiddler’s syndrome refers to the perma - nent malfunction of a pacemaker resulting from manip-ulation of the pulse generator within its skin pocket [1]. This leads to a rotation of the device, coiling of the lead and its dislodgement, leading to pacemaker failure. First described by Bayliss in 1968, it is a rare but poten-Early displacements are more frequent than late displacements and they usually affect atrial leads. The incidence of early displacements is 1% in VVI pacemakers and 5.2% in DDD pacemakers (3.8% of the cases affecting atrial leads and 1.4% ventricular leads). Acceptable displacement rates should probably be less than 1 percent for ventricular ...The pacemaker-twiddler’s syndrome refers to the permanent malfunction of a pacemaker resulting from manipulation of the pulse generator within its skin pocket [1]. This leads to a rotation of the device, coiling of the lead and its dislodgement, leading to pacemaker failure. What is the most common complication after permanent pacemaker ...The most frequent complication of pacemaker leads has been reported to be dislodgement, and the FOLLOWPACE study showed that dislocation of an atrial lead within 2 months was found in 1.9% of patients with active lead fixation and 3.9% of patients with passive lead fixation (P = .059). For a mean of 5.8 years except the first 2 months, its ...Jul 12, 2022 · The most common reason for lead extraction is device infection usually spreading to the lead from an infection of the blood (bacteremia). Heart valves may also become infected (infective endocarditis). In both cases, your healthcare provider will remove the device and leads. Additional reasons for lead extraction include: Citation, DOI, disclosures and article data. Lead dislodgement, also known as twiddler syndrome, is a complication of implanted cardiac conduction devices due to patient manipulation of the pulse generator, typically diagnosed on plain chest radiograph. A variation of this complication can also occur with implantable ports, deep brain ...identified causes of undersensing.3,4 As with failure to capture, the onset of undersensing relative to the time of device implantation helps identify the cause. Undersens-ing occurring shortly after implantation may be due to lead dislodgement or malposition or to cardiac perfora-tion. If it occurs later, it could be due to battery deple-CT scan of the patient does not usually cause problems in the pacemakers. Therefore, the presence of an implanted pacemaker should not hinder such investigative imaging modality. In rare cases, it might …Pacemaker lead displacement is very rare and usually occurs within a month of inplantation. I assume you are to attend a clinic in the next few weeks to ensure everything has settled down correctly? Displacement can still occur at any time after one month but is much more a rarer incidence and there is nothing specifically known to cause this.

The lead tip was minimally displaced; enough to produce an increase in capture threshold and eventually loss of capture while keeping near normal lead impedance values. Review of the literature shows that ventricular lead dislodgement after a motor vehicle accident is a rare incidence and cause of pacemaker malfunction.

The symptoms of pacemaker syndrome included dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, hypotension, pre-syncope, and even syncope . Heart failure signs include elevated neck veins, rales, and pedal edema. Physical exam can often reveal cannon A-waves.Moreover 1-2% of these patients will encounter severe lead-related problems within 30 days of their pacemaker insertion. In this report, we focus on an uncommon but serious complication of PPM insertion: right ventricular lead perforation leading to a pericardial effusion. Although lead perforation is a relatively rare occurrence, this event ...Additionally, two lead dislodgement-related syndrome is defined below: Lead displacement dysrhythmia refers to when free-floating ventricular leads cause episodes of malignant arrhythmias (12). When a lead is dislodged from the endocardial interface, the patient’s pacemaker dependency determines the symptoms (11). ...Citation, DOI, disclosures and article data. Lead dislodgement, also known as twiddler syndrome, is a complication of implanted cardiac conduction devices due to patient manipulation of the pulse generator, typically diagnosed on plain chest radiograph. A variation of this complication can also occur with implantable ports, deep brain ...The pacemaker-twiddler’s syndrome refers to the perma - nent malfunction of a pacemaker resulting from manip-ulation of the pulse generator within its skin pocket [1]. This leads to a rotation of the device, coiling of the lead and its dislodgement, leading to pacemaker failure. First described by Bayliss in 1968, it is a rare but poten-This phenomenon has been labelled “Idiopathic lead migration syndrome” and describes leads migrating from their original position (in the heart or pocket), with or without dislodgement or torsion, without a known cause [Citation 14]. In our study, the late dislodgement of the ICD lead in patient II was caused by migration from the RV to the ...25 Eyl 2012 ... The most common complications of pacemaker insertion are lead displacement and pacemaker infection [3]. Rarely a displaced lead may migrate ...Fractures in pacemaker leads during weightlifting have been reported. 3 In our patient, the cause was likely excessive movement of the upper limbs and direct trauma. Patients with implanted pacemakers should be reminded to avoid rigorous exercise of the upper limbs and direct compression of the chest wall. Our patient was fortunate not to be ...

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To minimize the risk of perforation, the surgeon should abstain from excessive advancement of the helix during lead fixation, excessive pressure on the lead, excessive loop, and forced dislodgement of the lead with an extended screw for instance due to dislocation of the atrial lead during the insertion of a ventricular lead, which should ...1 May 2017 ... DETECTING LEAD FRACTURE ... Symptoms of lead fracture vary, depending on the patient's pacemaker-dependency and on the degree of loss of capture ( ...The most frequent complication of pacemaker leads has been reported to be dislodgement, and the FOLLOWPACE study showed that dislocation of an atrial lead within 2 months was found in 1.9% of patients with active lead fixation and 3.9% of patients with passive lead fixation (P = .059). For a mean of 5.8 years except the first 2 months, its ...The most frequent complication of pacemaker leads has been reported to be dislodgement, and the FOLLOWPACE study showed that dislocation of an atrial lead within 2 months was found in 1.9% of patients with active lead fixation and 3.9% of patients with passive lead fixation (P = .059). For a mean of 5.8 years except the first 2 months, its ...Twiddler's syndrome, Lead dislodgement, Pacemaker malfunction Introduction. Twiddler's syndrome was first described by Bayliss, et al. in 1968, when a patient manipulated and rotated the pulse generator in the pocket resulting in lead dislodgement, diaphragmatic stimulation, and loss of capture . It occurs because of unintentional or deliberate ...The lead tip was minimally displaced; enough to produce an increase in capture threshold and eventually loss of capture while keeping near normal lead impedance values. Review of the literature shows that ventricular lead dislodgement after a motor vehicle accident is a rare incidence and cause of pacemaker malfunction.O Follow-up experience is needed with these modified leads to judge whether their use has reduced dislodgement rates and to determine if untoward prob- lems ...Dislodgement of the lead: Decubitus of the pocket and threatening decubitus: Improper location of the lead (left atrium, left ventricle, aorta, pulmonary trunk) ... Mechanical factors may cause pacemaker erosion. The incidence of permanent pacemaker perforation is between 0.5% and 2% . A mandatory echocardiographic follow-up evaluation is ... ….

Postprocedural complications of cardiovascular implantable electronic devices (CIEDs) are associated with increased patient morbidity, extended hospital stay, and higher healthcare costs. 1,2,3 Lead dislodgement (LD) is one of the most common complications of CIED implantation and has an incidence ranging from 1% to 8%. 2,4,7 LD has traditionally been defined as documentation of a change in ...Most frequent complications are those related to implantation procedure, such as lead dislodgement and pneumothorax. Implantation of dual chamber devices may be more challenging, however, the difference in complication rates between single and complex pacing is not consistent in all studies probably because of different use of technology and ...A Micro-dislodgement is a minimal displacement in the lead that is not visible in a chest X-ray, but has the ability to increase the capture threshold and eventually cause a loss of capture. Lead dislodgement can cause sensing failure, which occurs when proper atrial or ventricular sensing is not achieved by the programming of the pacemaker.Background Pacemaker lead dislodgement and failure, related to device manipulation, is a rare complication of permanent pacemaker (PPM) insertion. ... Twiddler's syndrome is a rare cause of ...Pacemaker-related complications are acceptable and they can mostly be resolved by minor interventions. The dislodgement of a pacemaker lead is one of the common complications and its incidence is estimated range from around 1-3％ ( 1 ). An active fixation lead is usually applied to avoid this complication, and a J-shaped passive …We tried to identify the causes of lead dislodgments. In almost 1/3 of the cases the sleeves on the leads were not fixed adequately and in 2/3 of the cases the cause of dislodgement was unclear. ... Right atrial and ICD leads caused more dislodgement compared with RV pacemaker leads. Lead perforation was more common with RV leads, especially ...Lead dislodgement of S-ICD is a rare complication; however, there have been reports of leads dislodgement with the two-incision technique , due to patient motion or manual movement of the S-ICD generator . We used the two-incision technique instead of three incisions for cosmetic reasons as the patient was a juvenile, but for patients that …Implantation of dual-chamber pacemakers in elderly patients does not correlate with a higher frequency of technical difficulties when compared to younger people, but patients ≥75 years of age are at an increased risk of early post-implantation complications (pneumothorax, both atrial and ventricular lead dislodgement, or loss of … Causes of pacemaker lead dislodgement, [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1], [text-1-1]