Annals of Pediatric Cardiology
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Table of Contents   
IMAGES  
Year : 2015  |  Volume : 8  |  Issue : 3  |  Page : 251-252
Pacemaker lead design masquerading as lead fracture


1 Department of Paediatric Cardiology, University Hospital Southampton NHS Trust, Southampton, UK
2 Department of Radiology, University Hospital Southampton NHS Trust, Southampton, UK

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Date of Web Publication7-Sep-2015
 

   Abstract 

Performing chest X-ray is an important annual investigation to check pacemaker lead integrity during follow-up of patients with pacemakers. Understanding lead design is vital to the correct interpretation of X-rays to prevent inappropriate interventions for patients as highlighted in this case.

Keywords: Correct interpretation of X-rays, pacemaker lead design, pacemaker lead fracture

How to cite this article:
Gangadhara M, Peebles C, Gnanapragasam J. Pacemaker lead design masquerading as lead fracture. Ann Pediatr Card 2015;8:251-2

How to cite this URL:
Gangadhara M, Peebles C, Gnanapragasam J. Pacemaker lead design masquerading as lead fracture. Ann Pediatr Card [serial online] 2015 [cited 2019 Aug 19];8:251-2. Available from: http://www.annalspc.com/text.asp?2015/8/3/251/158521



   Clinical summary Top


A 5-year-old girl with a permanent epicardial pacemaker implanted at 6 months of age for complete heart block following Tetralogy of Fallot repair, attended her annual pacemaker check.

She had a Medtronic Adapta epicardial pacemaker with unipolar atrial and bipolar ventricular leads. She was asymptomatic and her pacemaker check showed no abnormalities.

Chest X-ray [Figure 1] was initially reported as showing a lead fracture in one arm of her bipolar ventricular lead [[Figure 2], black arrow]. However, further review of the chest X-ray with an understanding of this bipolar lead design [[Figure 3], white arrow] enabled correction of this error in interpretation.
Figure 1: Chest X-ray for pacemaker leads check

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Figure 2: Chest X-ray reported as showing pacemaker lead fracture

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Figure 3: X-ray of unopened pacemaker lead to demonstrate lead design

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   Discussion Top


The connection between the two limbs of the bipolar lead consists of a short segment which is at right angles to the two limbs, and this area can appear relatively radiolucent mimicking a lead fracture.

Understanding the variations of pacemaker lead design is vital to avoid misinterpretation of chest X-rays when screening for lead integrity and can prevent inappropriate action. [1],[2]

 
   References Top

1.
Ellenbogen KA, Hellkamp AS, Wilkoff BL, Camunãs JL, Love JC, Hadjis TA, et al. Complications arising after implantation of DDD pacemakers: The MOST experience. Am J Cardiol 2003;92:740-1.  Back to cited text no. 1
    
2.
Udo EO, Zuithoff NP, van Hemel NM, de Cock CC, Hendriks T, Doevendans PA, et al. Incidence and predictors of short-and long-term complications in pacemaker therapy: The FOLLOWPACE study. Heart Rhythm 2012;9:728-35.  Back to cited text no. 2
    

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Correspondence Address:
Madhu Gangadhara
D level office, Department of Paediatric Cardiology, University Hospital Southampton NHS Trust, Tremona road, Southampton, SO16 6YD
UK
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2069.158521

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    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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