Case report An old ventricular lead migration and subsequent dislodgement to the pleural cavity – an unusual complication of permanent cardiac pacing

Abstract

A case of a 77 year old male with a history of multiple pacemaker replacement procedures, a new ventricular lead implanted and an old one left in place, and imminent skin erosion at the site of a pacemaker pocket is presented. Clinical diagnosis included right-sided heart failure, pneumonia, pleural effusion and suspicion of pulmonary infarction as well as endocarditis. Chest radiogram and computerised tomography revealed an unusual location of an old ventricular lead which proximal, sharp end migrated through the venous system via right ventricle and pericardium to the left pleural cavity.