Pneumomediastinum and right sided pneumothorax following dual chamber-ICD implantation.
A 64-year-old-male with ischemic cardiomyopathy and a severely reduced left ventricular ejection fraction underwent a left sided ICD implantation for primary prophylaxis. Given a history of sarcoidosis and bifasicular block on ECG, a dual chamber device was placed in anticipation of progressive conduction disease. The patient returned 2 days after implantation with a right sided tension pneumothorax. A chest tube was immediately placed with hemodynamic and clinical improvement. CT chest revealed extrusion of the atrial lead through the right atrial appendage. The atrial lead was removed without incident.
Rosman
Jonathan
J
Department of Cardiology, Beth Israel Medical Center, New York, NY 10003, USA.
Shapiro
Michael D
MD
Hanon
Sam
S
D002304:Cardiac Pacing, Artificial / Q000379:methods; D009202:Cardiomyopathies / Q000453:epidemiology; D015505:Chest Tubes; D015897:Comorbidity; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D008875:Middle Aged; D017202:Myocardial Ischemia; D011030:Pneumothorax / Q000209:etiology*; D012507:Sarcoidosis / Q000453:epidemiology; D017565:Sarcoidosis, Pulmonary / Q000453:epidemiology; D014057:Tomography, X-Ray Computed