4 cases of chest pains that developed after pacemaker lead implantation resolved by moving the leads in heart!
J Interv Card Electrophysiol. 2013 Dec 11. [Epub ahead of print]
Unusual chest pain syndromes caused by implanted cardiac device leads: a case series.
Witt CM, Best PJ, Asirvatham SJ, McLeod CJ.
- Usually pain aftetr chest lead implantation would suggest erosion or perforation ( on CT) of lead but these cases had none
- Pain types:
– constant sharp substernal, 3/10 severity, chest pain not aggravated by eating, breathing or position but exertional – initially low sternal but later higher in chest when moved
– localized midsternal; pain worse with recumbent and deep breath but different from prior angina – pleuritic
– squeezing central pressure with exercise though coronary angiogram normal
– Severe, sharp, “pinprick” sensation over the left chest
- They found that “coronary sinus pacing location is potentially less problematic” – better position
Comment – they could not rule out micorperforation but thought heart was hypersensitive – ? maybe a wounded heart :)…
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