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Chronic thromboembolic pulmonary hypertension secondary to implantable cardioverter defibrillator lead thrombus in a patient with Brugada syndrome: a rare complication requiring a multidisciplinary approach.
BMJ Case Rep. 2020 May 19; 13(5)BC

Abstract

We report the case of a 57-year-old male patient with prior syncope associated with sustained ventricular tachycardia in the setting of Brugada syndrome, who was submitted to implantation of a cardioverter defibrillator for secondary prevention. During follow-up, he presented a significant increase in lead impedance, and a transthoracic echocardiogram showed a mass attached to the lead. He was started on oral anticoagulation after infective endocarditis was excluded but nevertheless suffered repeated episodes of pulmonary embolism that led to severe chronic thromboembolic pulmonary hypertension. After heart team discussion, he was referred to pulmonary endarterectomy and replacement of the implantable cardioverter defibrillator with a subcutaneous device. This led to significant improvement of functional class and normalisation of pulmonary haemodynamics. More recently, he suffered syncope in the setting of ventricular fibrillation with appropriate shocks and was started on quinidine without further recurrence of arrhythmic episodes.

Authors+Show Affiliations

Pulmonary Hypertension Unit, Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal asofia.alegria@gmail.com.Pulmonary Hypertension Unit, Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal.Pulmonary Hypertension Unit, Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal.Pulmonary Hypertension Unit, Department of Cardiology, Hospital Garcia de Orta, Almada, Portugal.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32434878

Citation

Alegria, Sofia, et al. "Chronic Thromboembolic Pulmonary Hypertension Secondary to Implantable Cardioverter Defibrillator Lead Thrombus in a Patient With Brugada Syndrome: a Rare Complication Requiring a Multidisciplinary Approach." BMJ Case Reports, vol. 13, no. 5, 2020.
Alegria S, Ferreira F, Repolho D, et al. Chronic thromboembolic pulmonary hypertension secondary to implantable cardioverter defibrillator lead thrombus in a patient with Brugada syndrome: a rare complication requiring a multidisciplinary approach. BMJ Case Rep. 2020;13(5).
Alegria, S., Ferreira, F., Repolho, D., & Loureiro, M. J. (2020). Chronic thromboembolic pulmonary hypertension secondary to implantable cardioverter defibrillator lead thrombus in a patient with Brugada syndrome: a rare complication requiring a multidisciplinary approach. BMJ Case Reports, 13(5). https://doi.org/10.1136/bcr-2020-234549
Alegria S, et al. Chronic Thromboembolic Pulmonary Hypertension Secondary to Implantable Cardioverter Defibrillator Lead Thrombus in a Patient With Brugada Syndrome: a Rare Complication Requiring a Multidisciplinary Approach. BMJ Case Rep. 2020 May 19;13(5) PubMed PMID: 32434878.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic thromboembolic pulmonary hypertension secondary to implantable cardioverter defibrillator lead thrombus in a patient with Brugada syndrome: a rare complication requiring a multidisciplinary approach. AU - Alegria,Sofia, AU - Ferreira,Filipa, AU - Repolho,Débora, AU - Loureiro,Maria José, Y1 - 2020/05/19/ PY - 2022/05/19/pmc-release PY - 2020/5/22/entrez PY - 2020/5/22/pubmed PY - 2020/5/22/medline KW - arrhythmias KW - pulmonary embolism KW - pulmonary hypertension JF - BMJ case reports JO - BMJ Case Rep VL - 13 IS - 5 N2 - We report the case of a 57-year-old male patient with prior syncope associated with sustained ventricular tachycardia in the setting of Brugada syndrome, who was submitted to implantation of a cardioverter defibrillator for secondary prevention. During follow-up, he presented a significant increase in lead impedance, and a transthoracic echocardiogram showed a mass attached to the lead. He was started on oral anticoagulation after infective endocarditis was excluded but nevertheless suffered repeated episodes of pulmonary embolism that led to severe chronic thromboembolic pulmonary hypertension. After heart team discussion, he was referred to pulmonary endarterectomy and replacement of the implantable cardioverter defibrillator with a subcutaneous device. This led to significant improvement of functional class and normalisation of pulmonary haemodynamics. More recently, he suffered syncope in the setting of ventricular fibrillation with appropriate shocks and was started on quinidine without further recurrence of arrhythmic episodes. SN - 1757-790X UR - https://www.unboundmedicine.com/medline/citation/32434878/Chronic_thromboembolic_pulmonary_hypertension_secondary_to_implantable_cardioverter_defibrillator_lead_thrombus_in_a_patient_with_Brugada_syndrome:_a_rare_complication_requiring_a_multidisciplinary_approach L2 - https://casereports.bmj.com/cgi/pmidlookup?view=long&pmid=32434878 DB - PRIME DP - Unbound Medicine ER -
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