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Korean J Med > Volume 88(2); 2015 > Article
The Korean Journal of Medicine 2015;88(2): 197-201.
인공 심박 조율기 전극 골절을 전극 수선 및 정맥 성형술로 치료한 1예
김지은, 윤남식, 박형욱, 조정관
전남대학교 의과대학 전남대학교병원 순환기내과
Pacemaker Lead Fracture Treated with Splinting and Venoplasty
Ji Eun Kim, Nam Sik Yoon, Hyung Wook Park, Jeong Gwan Cho
Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
Corresponding Author: Nam Sik Yoon ,Tel: +82-62-220-6272, Fax: +82-62-220-6272, Email: yoonnamsik@gmail.com
Received: May 15, 2014;   Revised: July 17, 2014;   Accepted: August 11, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
A 56-year-old man was admitted for pacemaker generator replacement. We identified a partial fracture in the proximal part of the lead just after the conjunction of the atrial and ventricular leads. The atrial lead sensitivity was stable even under intentional pulling and twisting. We deployed a splint made of a suture-sleeve in the fracture site. After burying the malfunctioning ventricular connector behind the pocket, we inserted only a new ventricular lead. However, another complication existed. Venogram showed a total occlusion between the brachiocephalic vein and superior vena cava. After meticulous wiring, we passed the target and dilated the vessel with 8 and 9 Fr dilators. Finally, a new ventricular lead and generator were inserted via a long peel-away sheath. In conclusion, we successfully treated a patient with a partial lead fracture and a brachiocephalic vein occlusion using splinting and venoplasty.
Keywords: Electrodes, Pacemaker, Artifical; Equipment failure; Therapeutics; Angioplasty
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