title: Massive transient pulmonary air embolism during pacemaker implantation under mild sedation: an unrecognized hazard of snoring.
abstract: We present a case of a massive pulmonary air embolism during permanent pacemaker lead implantation under mild sedation in a 73-year-old woman. We used a peel-away sheath that is devoid of a hemostatic valve. The air embolism occurred after deep inspiration associated with loud snoring sounds and resolved after short chest massage and administration of adrenaline. Temporary closure of the intravenous entrance route of the peel-away sheath before inserting the lead may prevent this potentially lethal complication.
authors.affiliation: Department of Cardiology, Ha'Emek Medical Center, Afula, Israel. yoav_t@clalit.org.il
authors.forename: Yoav
authors.initials: Y
authors.lastname: Turgeman
authors.forename: Dante
authors.initials: D
authors.lastname: Antonelli
authors.forename: Shaul
authors.initials: S
authors.lastname: Atar
authors.forename: Tiberio
authors.initials: T
authors.lastname: Rosenfeld
mesh_terms: D000368:Aged; D016292:Procedural Sedation; D004618:Embolism, Air / Q000209:etiology*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D010138:Pacemaker, Artificial; D011655:Pulmonary Embolism / Q000209:etiology*; D012913:Snoring / Q000150:complications*