BACKGROUND The CHA2DS2-VASc score is used clinically for stroke risk stratification in patients with atrial fibrillation (AF). We sought to investigate whether the CHA2DS2-VASc score predicts stroke and death in Chinese patients with sick sinus syndrome (SSS) after pacemaker implantation and to evaluate whether the predictive power of the CHA2DS2-VASc score could be improved by combining it wit...

Transthoracic 2-dimensional (D) echocardiography (echo) is often used to assess tricuspid regurgitation (TR) after implantation of permanent pacemakers. However, its ability to define the precise anatomical relationship between the tricuspid valve and the pacemaker lead is quite limited. This report presents a 58-year-old male with aggravation of TR after pacemaker implantation for heart block....

Electrode instability and displacement have been reported in patients who underwent pacemaker implantation via persistent left superior vena cava. An active-fixation system, and sometimes epicardial pacing, is necessary to maintain pacing stability. We report the case of a 76-year-old man with a left superior vena cava who required dual-chamber permanent pacing. Passive-fixation atrial and vent...

BACKGROUND Previous reports have suggested the occurrence of cardiac conduction disorders and permanent pacemaker (PPM) requirement after transcatheter aortic valve implantation (TAVI). Based on a single-center experience, we aim to assess the incidence of postprocedural conduction disorders, need for PPM, and its determinants after TAVI with a self-expanding bioprosthesis. METHODS From Augus...

The classic transvenous implantation of a permanent pacemaker in a pectoral location may be precluded by obstruction of venous access through the superior vena cava or recent infection at the implant site. When these barriers to the procedure are bilateral and there are also contraindications or technical difficulties to performing a thoracotomy for an epicardial approach, the femoral vein, alt...

89 coaptation, the patient was scheduled for tricuspid valve annuloplasty with concurrent implantation of an epicardial ventricular lead and pacemaker. The operation was preceded by the transvenous extraction of the old ventricular lead. Due to advanced tricuspid valve lesions, a decision was made during surgery to perform artificial tricuspid valve implantation (Medtronic ATS 33 mm). Simultane...

Tricuspid stenosis related to endocardial pacemaker leads is uncommon. We report the case of a patient with severe tricuspid stenosis documented 15 years after the implantation of a permanent DDD pacemaker for symptomatic congenital heart block. The atrial and ventricular leads both had a loop at the level of the tricuspid valve that may have caused endothelial damage and, eventually, tricuspid...

Twoweeks after dual-chamber pacemaker implantation, a 51-year-oldman presented typical signs of pacemaker pocket infection. Device and leadswere explanted.As the local pain persisted and even extended to the left clavicle, amagnetic resonancewas performed and acute osteomyelitis of the left clavicle was diagnosed. Nine months later, a nearly complete resolution of the osteomyelitic focus was ob...

The twiddler syndrome is an uncommon cause of pacemaker malfunction, in which twisting or rotating of the device in its pocket results in lead retraction or coiling and subsequent malfunction of an implanted devices such as a pacemaker, an implantable cardioverter-defibrillator (ICD), cardiac resynchronization therapy (CRT).  This report describes a rare case of twiddler syndrome after implant...

Transvenous cardiac pacemakers definitely improve quality of life and reduce mortality in at-risk patients, but they are associated with several potential device-related complications. Approximately 10% of patients experience complications related to transvenous implantation of the pacemaker. These may be attributable to either the pulse generator (hematoma, skin breakdown, pocket infection) or...