A Case of Very Early Lead Fracture in an Implantable Cardioverter-Defibrillator: Management and Follow-Up

Pacing Clin Electrophysiol. 2025 Jan;48(1):68-71. doi: 10.1111/pace.15103. Epub 2024 Nov 19.

Abstract

Introduction: Implantable cardioverter defibrillators (ICDs) lead fractures are rare but serious complications, often leading to inappropriate shocks. The early occurrence of such fractures post-implantation is exceptionally uncommon.

Methods and results: We present a case of a 53-year-old male with hypertrophic cardiomyopathy who experienced an inappropriate shock due to a lead fracture just 4 days after ICD implantation. The fractured lead was successfully extracted and replaced using a gooseneck snare passed through an oversized TightRail with no immediate complications.

Conclusion: Early lead fractures can occur shortly after ICD implantation, leading to inappropriate shocks. Successful management, including extraction and reimplantation, is possible even in these early cases. Clinicians should remain vigilant, and remote monitoring can play a crucial role in the timely detection of such complications.

Keywords: ICD lead fracture; hypertrophic cardiomyopathy; inappropriate shock; lead extraction; remote monitoring.

Publication types

  • Case Reports

MeSH terms

  • Cardiomyopathy, Hypertrophic / therapy
  • Defibrillators, Implantable* / adverse effects
  • Device Removal
  • Electrodes, Implanted / adverse effects
  • Equipment Failure*
  • Humans
  • Male
  • Middle Aged