case_images: PMC11704095_01
case_images: A fluoroscopy image showing unraveled spring of the epicardial lead. B Electrocardiogram showing complete atrioventricular dissociation with a rate of 100 per minute and V rate of 50 per minute)
case_images: 43044_2024_598_Fig1_HTML.jpg
case_images: PMC11704095_01_43044_2024_598_Fig1_HTML.jpg
case_images: Fig1
case_images: One year after this, he presented with syncopal episodes, and pacemaker interrogation revealed increased lead impedance and elevated pacing thresholds, with fluoroscopy showing an unraveled epicardial lead, indicating lead malfunction (as shown in Fig. 1A). Electrocardiogram showed complete AV dissociation (as shown in Fig. 1B). Hg) (as shown in Fig. 2 and Video 1). However, patient has no right-sided heart failure symptoms.
case_images: Echocardiogram showing apical 4 chamber view with color Doppler showing turbulent flow across tricuspid valve (off-set image showing continuous wave Doppler tracings with peak gradient of 8 mm Hg and mean gradient of 4 mm Hg)
case_images: 43044_2024_598_Fig2_HTML.jpg
case_images: PMC11704095_01_43044_2024_598_Fig2_HTML.jpg
case_images: Fig2
case_images: Hg) (as shown in Fig. 2 and Video 1). However, patient has no right-sided heart failure symptoms.
case_images: Fluoroscopy image showing Tyshak balloon being inflated across tricuspid valve
case_images: 43044_2024_598_Fig3_HTML.jpg
case_images: PMC11704095_01_43044_2024_598_Fig3_HTML.jpg
case_images: Fig3
case_images: Then, an Amplatz super stiff wire was parked distally in the pulmonary artery branches. Then, a 20 x 40 mm Tyshak Balloon (NuMED ) was inflated across the TV (as shown in Fig. 3) (Video 2).
case_images: Fluoroscopy image showing dual-chamber device with right atrial lead in right atrial appendage and ventricular lead in one of the coronary sinus tributaries
case_images: 43044_2024_598_Fig4_HTML.jpg
case_images: PMC11704095_01_43044_2024_598_Fig4_HTML.jpg
case_images: Fig4
case_images: A dual-chamber generator was connected (as shown in Fig. 4 and Video 4).