Hostname: page-component-77c89778f8-sh8wx Total loading time: 0 Render date: 2024-07-18T23:35:05.478Z Has data issue: false hasContentIssue false
  • English
  • Français

Cardiac strangulation after epicardial pacing: the importance of non-specific symptoms and a low index of suspicion

Published online by Cambridge University Press:  19 November 2020

Margaret L. Morrison ,
Steven Karayiannis ,
Simone Speggiorin ,
Andrew J. Sands  and
Eric Rosenthal Open the ORCID record for Eric Rosenthal [Opens in a new window]
Margaret L. Morrison*
Affiliation:
Department of Paediatric Cardiology, Evelina London Children’s Hospital, London, UK
Steven Karayiannis
Affiliation:
Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
Simone Speggiorin
Affiliation:
Department of Cardiothoracic Surgery, Evelina London Children’s Hospital, London, UK
Andrew J. Sands
Affiliation:
Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland
Eric Rosenthal
Affiliation:
Department of Paediatric Cardiology, Evelina London Children’s Hospital, London, UK
*
Author for correspondence: Dr Margaret L. Morrison, Department of Paediatric Cardiology, Evelina London Children’s Hospital, London, UK. Tel: +44 020 7188 7188. E-mail: louisemorrison@doctors.org.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Cardiac strangulation is a rare and potentially deadly complication of epicardial pacemaker implantation. A young boy presenting with chest pain and tiredness almost 7 years after pacemaker implantation was found to have cardiac strangulation. Literature review revealed 22 cases reported to date with a worrying rise in the number of reports over the past 3 years. Strangulation is associated with implantation of leads at a young age and appears to be related to somatic growth. Serial assessment with chest X-ray and echocardiogram is recommended, at least until full adult growth is attained with further coronary artery imaging reserved for symptoms or suspicious echocardiographic findings. If cardiac strangulation is diagnosed prompt replacement of the offending system is needed.

Keywords

Pacingcomplicationscardiac strangulation
Type
Brief Report
Information
Cardiology in the Young , Volume 31 , Issue 1 , January 2021 , pp. 159 - 162
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Eyskens, B, Mertens, L, Moerman, P, et al. Cardiac strangulation, a rare complication of epicardial pacemaker leads during growth. Heart 1997; 77: 288–289.CrossRefGoogle ScholarPubMed
Watanabe, H, Hayashi, J, Sugawara, M, et al. Cardiac strangulation in a neonatal case: a rare complication of permanent epicardial pacemaker leads. Thorac Cardiovasc Surg 2000; 48: 103–105.CrossRefGoogle Scholar
Carerras, EM, Duncan, WJ, Djurdjev, O, et al. Cardiac strangulation following epicardial pacemaker implantation: a rare pediatric complication. J Thorac Cardiovasc Surg 2015; 149: 522–527.CrossRefGoogle Scholar
Janik, M, Hejna, P, Straka, L, et al. Strangulation of the heart presenting as sudden cardiac death: a deadly but forgotten complication of epicardial pacing device. Legal Med 2018; 32: 107–112.CrossRefGoogle ScholarPubMed
Mah, DY, Prakash, A, Porras, D, et al. Coronary artery compression from epicardial leads: more common than we think. Heart Rhythm 2018; 15: 1439–1447.CrossRefGoogle ScholarPubMed
Takeuchi, D, Tomizawa, Y. Cardiac strangulation from epicardial pacemaker leads: diagnosis, treatment and prevention. Gen Thorac Cardiovasc Surg 2015; 63: 22–29.CrossRefGoogle Scholar
AlHuzaimi, A, Roy, N, Duncan, WJ. Cardiac strangulation from epicardial pacemaker: early recognition and prevention. Cardiol Young 2011; 21: 471–473.CrossRefGoogle ScholarPubMed
Brenner, JJ, Gaines, S, Cordier, J, et al. Cardiac strangulation: two dimensional echo recognition of a rare complication of epicardial pacemaker therapy. Am J Cardiol 1988; 61: 654–656.CrossRefGoogle ScholarPubMed