Cor Vasa 2010, 52(4):270-274 | DOI: 10.33678/cor.2010.065

Cumulation of complications in a patient with arrhythmogenic right ventricular dysplasia after primary implantation of single-chamber ICD

Ingrid Sovová^*, Martin Hutyra, Miloš Táborský, Tomáš Skála, Jan Galuszka

I. interní klinika, Fakultní nemocnice Olomouc, Česká republika

Arrhythmogenic right ventricular dysplasia is a rare cause of collapse, most frequently due to ventricular tachycardia. In patients with documented ventricular tachycardia, cardioverter-defibrillator (ICD) implantation to prevent sudden cardiac death is indicated. In the presented case, ICD implantation was complicated with a ventricular defibrillation lead perforating into front mediastinum requiring lead extraction and subsequent reimplantation of a new lead into the right ventricular outflow tract. A week later, the patient developed sepsis due to mediastinitis, pericarditis, and jugular vein thrombosis. Echocardiography and chest computer tomography were used to verify the diagnosis. The whole ICD system had to be explanted again, and after antibiotic treatment, a new one was reimplanted with septal positioning of the defibrillation lead. The patient continues to be followed up using remote monitoring, a total 52 ventricular tachycardia episodes were documented over a period of 14 months.

Keywords: Cardioverter-defibrillator implantation; Implantation complications; Mediastinitis; Lead perforation

Published: April 1, 2010  Show citation