Successful thrombolysis of right atrial and ventricle thrombi encircling a temporary pacemaker lead in a patient with heparin-induced thrombocytopenia type II.
Only few reports exist addressing the problem of temporary pacemaker leads associated with thromboembolic disease. We report the case of a 67-year-old patient who required a temporary transfemoral pacemaker due to AV block grade III. The patient developed extensive right atrial and ventricle thrombus formation attached to the pacing wire, as well as venous thrombosis at the insertion site due to heparin-induced thrombocytopenia type II (HIT type II). After short-term thrombolysis with 1 mg rt-PA/kg b.w. complete resolution of all clots could be shown by B-mode sonography and transthoracic, as well as transesophageal echocardiography.
Janssens
U
U
Medical Clinic I, University of RWTH Aachen, Germany.
Breithardt
O A
OA
Greinacher
A
A
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002809:Chondroitin Sulfates / Q000008:administration & dosage / Q000627:therapeutic use; D003871:Dermatan Sulfate / Q000008:administration & dosage / Q000627:therapeutic use; D004338:Drug Combinations; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006325:Heart Atria; D006331:Heart Diseases / Q000188:drug therapy*; D006352:Heart Ventricles; D006493:Heparin / Q000009:adverse effects*; D006496:Heparinoids / Q000008:administration & dosage / Q000627:therapeutic use; D006497:Heparan Sulfate / Q000008:administration & dosage / Q000627:therapeutic use; D024764:Hirudin Therapy; D006629:Hirudins / Q000008:administration & dosage; D006801:Humans; D010138:Pacemaker, Artificial; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000145:classification; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
D000925:Anticoagulants; D002809:Chondroitin Sulfates; D003871:Dermatan Sulfate; D004338:Drug Combinations; D005343:Fibrinolytic Agents; D006493:Heparin; D006496:Heparinoids; D006497:Heparan Sulfate; D006629:Hirudins; D010959:Tissue Plasminogen Activator; C035838:danaparoid