Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2022; 10(33): 12352-12357
Published online Nov 26, 2022. doi: 10.12998/wjcc.v10.i33.12352
Pacemaker electrode rupture causes recurrent syncope: A case report
Xiao-Yong Zhu, Xin-Hu Tang, Wen-Yin Huang
Xiao-Yong Zhu, Xin-Hu Tang, Wen-Yin Huang, Department of Cardiology, Jiujiang University Affiliated Hospital, Jiujiang 332000, Jiangxi Province, China
Author contributions: Zhu XY reviewed the literature and contributed to manuscript drafting and revising; Zhu XY was the patient’s doctors and contributed to collecting the patient’s medical data and making a revision to the manuscript; Huang WY Completed surgery and recorded surgical images, Tang XH was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Hu Tang, MD, Chief Physician, Doctor, Department of Cardiology, Jiujiang University Affiliated Hospital, No. 57 Road, Xunyang District, Jiujiang 332000, Jiangxi Province, China. 18879292198@163.com
Received: July 19, 2022
Peer-review started: July 19, 2022
First decision: September 25, 2022
Revised: October 4, 2022
Accepted: October 19, 2022
Article in press: October 19, 2022
Published online: November 26, 2022
Abstract
BACKGROUND

Currently, the implantation of permanent cardiac pacemakers entails mostly subclavian vein puncture, which is relatively simpler and easier to master. However, due to individual differences, some patients carry a narrow space between the clavicle and the first rib. If the range of activity of the upper limb is increased, the friction between the electrode wire and the bone gap leads to the breakage of the electrode wire, which is manifested by poor pacemaker perception and pacing.

CASE SUMMARY

A 68-year-old woman underwent permanent pacemaker implantation in our hospital because of third-degree atrioventricular block 6 years ago. At that time, the patient was recommended to have a dual-chamber permanent pacemaker implantation, and finally chose a single-chamber permanent pacemaker because she could not afford the cost. The patient has repeatedly lost consciousness for no obvious reason in the past 3 d, and went to our hospital for treatment. The chest X-ray showed that the pacemaker electrode was broken. After the patient was given a pacemaker electrode replacement, the patient did not continue to lose consciousness.

CONCLUSION

Because the electrodes implanted in the subclavian approach are close to the clavicle and the first rib, the pacemaker electrodes may wear out. If the patient loses consciousness again after the pacemaker is implanted, we should consider whether there is a pacemaker. The possibility of electrode breakage, and timely help the patient to replace the new pacemaker electrodes.

Keywords: Syncope, Pacemaker, Lead fracture, Subclavian crush, Case report

Core Tip: We treated a patient who was implanted with a single-chamber pacemaker 6 years ago. The patient experienced repeated loss of consciousness 3 d ago without obvious incentives. The patient did not continue to lose consciousness after the pacemaker electrodes were replaced.