1. Erwan Salaun et al. JACEP 2017;j.jacep.2016.12.028
An Oscillating Mass Attached to a Pacemaker Lead (A) Initial findings with multi-imaging assessment: (top left) bicaval transesophageal echocardiographic (TEE) view of the atrial lead loop (black star) of the cardiac implantable electronic device with 2 oscillating masses (a larger mass highlighted by the red arrow and a smaller mass highlighted by a red dashed arrow) (online videos 1 and 2); (top right) measurement of the larger mass; (bottom left) computed tomography scan view of the atrial lead (black star) with the larger oscillating mass (red arrow); (bottom right) view of 18F-fluorodeoxyglucose positron emission tomography/computed tomography through the right-cardiac cavities without abnormal uptake on the atrial lead of the cardiac implantable electronic device. (B) TEE bicaval view 2 weeks after empirical antibiotherapy and 1 week after continuous intravenous infusion of unfractionated heparin with the increased larger mass (red arrow) (online video 3) measured at 2.4 cm on the atrial lead (black star). (C) Transgastric TEE view during the snare retrieval procedure. The deflectable sheath was advanced through a right femoral vein access (online video 4) and the triple-loop wire snare (purple dashed arrows) was directed toward the atrial lead (black star) and the mass (red arrow), which was totally retrieved (online videos 5 and 6). (D) Visual examination of the retrieved mass. IVC = inferior vena cava; LA = left atrium; RA = right atrium; RV = right ventricle; SVC = superior vena cava.
Erwan Salaun et al. JACEP 2017;j.jacep
2017 American College of Cardiology Foundation