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| Year : 2015
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: 8 | Issue : 3 | Page
: 251-252 |
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| Pacemaker lead design masquerading as lead fracture |
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Madhu Gangadhara1, Charles Peebles2, James Gnanapragasam1
1 Department of Paediatric Cardiology, University Hospital Southampton NHS Trust, Southampton, UK
2 Department of Radiology, University Hospital Southampton NHS Trust, Southampton, UK
Click here for correspondence address and
email
| Date of Web Publication | 7-Sep-2015 |
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 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 |
| Clinical summary | |  |
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.
| Discussion | | |
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 | | |
| 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.  |
| 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. |
Correspondence Address:
Madhu Gangadhara
D level office, Department of Paediatric Cardiology, University Hospital Southampton NHS Trust, Tremona road, Southampton, SO16 6YD
UK
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0974-2069.158521
[Figure 1], [Figure 2], [Figure 3] |
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