Right bundle branch block after transvenous lead extraction -- A
previously unreported complication of transvenous lead extraction with
potentially devastating consequences
Abstract
Introduction: Right bundle branch block (RBBB) following
cardiac device extraction has not been previously reported but may have
catastrophic consequences. Methods and Results: We present two
cases of young male patients who developed right bundle branch block
following the extraction of single chamber TV ICD systems where the coil
was adherent close to the superior tricuspid valve annulus. Both
patients had a subcutaneous ICD (SICD) implanted but suffered an
inappropriate shock due to T-wave oversensing, requiring very early SICD
removal for one patient. Conclusion: The development of RBBB
following the extraction of a TV ICD is a previously unreported
complication and may cause significant sensing problems if an SICD is
implanted subsequently. Placement of the ICD lead tip in the right
ventricular outflow tract or high on the intraventricular septum may
predispose to this complication.