1/15. Migration and infection of a pace-sense lead from an abdominal defibrillator system.A 47-year-old man had an ICD system with epicardial and endocardial components and an abdominal generator placed in 1990 following a cardiac arrest. Ten years later his BT10 lead was amputated due to an insulation defect, and he received a new pectoral generator with transvenous leads. A few months later he developed fevers, chills, and bacteremia. Evaluation demonstrated migration of the entire BT10 lead into the right atrium. Complete surgical explantation was required and the bacteremia resolved. This case illustrates the importance of solid anchoring of distal lead components following generator removal and the potential complication of intravascular lead migration.- - - - - - - - - - ranking = 1keywords = generator (Clic here for more details about this article) |
2/15. Early pacemaker twiddler syndrome.Twiddler's syndrome is a well-known complication of pacemaker treatment. It was first described by Bayliss et al. when a patient manipulated and rotated the pulse generator in the pocket so many turns that it resulted in lead dislodgment, diaphragmatic stimulation and loss of capture. In this case report we present a patient who managed to rotate her dual chamber pulse generator so quickly after implantation that exit block occurred within 17 h. She had wound the two leads as far as their tips in a perfect formation around the pulse generator.- - - - - - - - - - ranking = 1keywords = generator (Clic here for more details about this article) |
3/15. Reel syndrome and pulsatile liver in a patient with a two-chamber pacemaker.Twiddler's syndrome is characterized by coiling of the pacemaker lead due to the rotation of the pacemaker generator on its long axis. Reel syndrome is another form of Twiddler's syndrome. It occurs due to the rotation of the pacemaker generator on its transverse axis with subsequent coiling of the pacemaker leads around the pulse generator. In this article we describe a patient with a two-chamber pacemaker who presented with sudden onset of abdominal pulsation and was subsequently diagnosed as Reel syndrome. To the best of our knowledge, this case is the first case of Reel syndrome that developed in a patient with a two-chamber pacemaker.- - - - - - - - - - ranking = 1keywords = generator (Clic here for more details about this article) |
4/15. A migrating pacemaker.A deceased 79 year old man with a permanent cardiac pacemaker was due to be cremated, but the pacemaker generator was not detectable by palpation. A hand held metal detector to locate the device so that it could be extracted before cremation.- - - - - - - - - - ranking = 0.33333333333333keywords = generator (Clic here for more details about this article) |
5/15. Unusual cause of dysuria: migration of a pacemaker generator into the urinary bladder.Following pacemaker implantation, a 71-year-old female developed infection of the generator pocket. Five years after relocation posterior to the rectus muscle she suffered from cystitis. cystoscopy revealed the pacemaker generator to be lying within the urinary bladder. Healing was achieved by removing the pacemaker and reutilizing it, after sterilization, in a new pectoral pocket.- - - - - - - - - - ranking = 2keywords = generator (Clic here for more details about this article) |
6/15. Intraventricular migration of an ICD patch.A 42-year-old man presented with fever and weight loss 12 months after ICD replacement. After unsuccessful search for an infected focus and a specific antibiotic treatment ICD pocket was explored and staphylococcus epidermidis was cultured. Following generator explanation fever recurred and at a second operation one ICD patch was found to have perforated in the right ventricular cavity. Explanation of the patches was performed on cardiopulmonary bypass, the patient survived the operation and infection was eradicated.- - - - - - - - - - ranking = 0.33333333333333keywords = generator (Clic here for more details about this article) |
7/15. Intracolonic migration of a pacemaker generator.Following pacemaker implantation, a 75-year-old male developed a low grade infection of the generator pocket. Utilizing the same generator, several relocations of the generator were made with the result that eventually the pacemaker, eroding the muscular planes, found his way into the ascending colon. Healing could be achieved only after removing the whole pacemaker system. The authors' current policy in case of pacemaker infection is also reported.- - - - - - - - - - ranking = 2.3333333333333keywords = generator (Clic here for more details about this article) |
8/15. Twiddler's syndrome: a new twist.Twiddler's syndrome, characterized by dislodgment of pacemaker leads due to twisting of pulse generators within the subcutaneous pocket with subsequent retraction of leads and loss of pacing function, has been well described in patients with permanent pacemakers implanted for bradyarrhythmias. The case presented here is the first report of a patient with an internal automatic cardioverter-defibrillator with lead dislodgment due to pulse generator rotation. This case exemplifies a new subset of patients prone to the Twiddler's syndrome.- - - - - - - - - - ranking = 0.66666666666667keywords = generator (Clic here for more details about this article) |
9/15. Migration of an epicardial pacemaker to the pericardial space in an infant.We report the case of a 4-month-old infant who was implanted with an epicardial ventricular pacing system at 6 days of age for the prolonged QT syndrome, who subsequently developed migration of the pulse generator to the pericardial space. Tracking of the pulse generator through the diaphragm and into the pericardium followed the route of the myocardial lead. The possibility of pulse generator migration, as well as disruption of the diaphragm and pericardium, should be considered by those who care for infants with implanted pacemakers.- - - - - - - - - - ranking = 1keywords = generator (Clic here for more details about this article) |
10/15. carcinoma of the breast at the site of migrated pacemaker generators.We report two patients in whom breast malignancy developed in the proximity of 'migrated' pacemaker generators. These cases and the similar ones reported in the literature raise concerns whether this association is merely coincidental or whether the pacemaker generator is responsible for the occurrence in some inexplicable manner. We urge for a routine, careful examination in all patients with implanted pacemaker generators at follow-up visits. This would help in (a) timely detection of migration of the pacemaker generators and (b) earlier diagnosis of any mass developing close to the migrated generators.- - - - - - - - - - ranking = 3keywords = generator (Clic here for more details about this article) |
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