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Peer-reviewedCC BY-NC-ND 4.0JACC Case Reports

Dual Rare Lead-Related Complications

  • Pierre-Léo Laporte1
  • Gauthier Giordano1
  • Géraldine Vedrenne1
  • Anne Messali1
  • Fabrice Extramiana1
  • Vincent Algalarrondo1
  1. 1Reference Center for Inherited Arrhythmic Syndromes, Hôpital Bichat, APHP, Université Paris Cité, Paris, France
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Abstract

Background: LMNA-related dilated cardiomyopathy is associated with ventricular remodeling and a high arrhythmic risk, frequently requiring implantable cardioverter-defibrillator (ICD) implantation. Although transvenous systems are generally safe, rare lead-related complications may occur.

Case Summary: We report a 51-year-old man with LMNA-related dilated cardiomyopathy who experienced 2 rare and sequential ICD lead complications. An initially septal right-ventricular lead was complicated by myocardial transfixion because of anterior apical positioning, revealed by cardiac computed tomography after a rise in pacing thresholds. During reintervention, a second lead was implanted but was later found to have traversed an unrecognized sinus venosus atrial septal defect with partial anomalous pulmonary venous return, resulting in inadvertent left-ventricular lead placement. The lead was successfully repositioned under transesophageal echocardiographic guidance. Three-dimensional computed tomography reconstruction clearly demonstrated both abnormal lead positions.

Discussion and Take-Home Message: This case highlights the importance of systematic troubleshooting, awareness of altered anatomy, and multimodality imaging during ICD implantation.

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Cite

BibTeXRIS
BibTeX
@article{laporte2026dual,
  title = {{Dual Rare Lead-Related Complications}},
  author = {Pierre-Léo Laporte and Gauthier Giordano and Géraldine Vedrenne and Anne Messali and Fabrice Extramiana and Vincent Algalarrondo},
  journal = {JACC Case Reports},
  year = {2026},
  month = aug,
  doi = {10.1016/j.jaccas.2026.109927},
  url = {https://doi.org/10.1016/j.jaccas.2026.109927},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Dual Rare Lead-Related Complications
AU  - Pierre-Léo Laporte
AU  - Gauthier Giordano
AU  - Géraldine Vedrenne
AU  - Anne Messali
AU  - Fabrice Extramiana
AU  - Vincent Algalarrondo
PY  - 2026
DA  - 2026/08/22
JO  - JACC Case Reports
DO  - 10.1016/j.jaccas.2026.109927
UR  - https://doi.org/10.1016/j.jaccas.2026.109927
AB  - Background: LMNA-related dilated cardiomyopathy is associated with ventricular remodeling and a high arrhythmic risk, frequently requiring implantable cardioverter-defibrillator (ICD) implantation. Although transvenous systems are generally safe, rare lead-related complications may occur.  Case Summary: We report a 51-year-old man with LMNA-related dilated cardiomyopathy who experienced 2 rare and sequential ICD lead complications. An initially septal right-ventricular lead was complicated by myocardial transfixion because of anterior apical positioning, revealed by cardiac computed tomography after a rise in pacing thresholds. During reintervention, a second lead was implanted but was later found to have traversed an unrecognized sinus venosus atrial septal defect with partial anomalous pulmonary venous return, resulting in inadvertent left-ventricular lead placement. The lead was successfully repositioned under transesophageal echocardiographic guidance. Three-dimensional computed tomography reconstruction clearly demonstrated both abnormal lead positions.  Discussion and Take-Home Message: This case highlights the importance of systematic troubleshooting, awareness of altered anatomy, and multimodality imaging during ICD implantation.
SN  - 2666-0849
ER  -