
Fractured Guidewire during Left Ventricular Lead Insertion: A First Case Report
Author(s) -
Nishihara Shuzo,
Anzai Hitoshi,
Nishi Yuhtaro,
Takao Nobuhiro,
Hayashida Noriaki
Publication year - 2010
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/s1880-4276(10)80027-4
Subject(s) - medicine , cardiology , left bundle branch block , qrs complex , ventricular dyssynchrony , cardiac resynchronization therapy , heart failure , ejection fraction
We report on a 77‐year‐old man who had been diagnosed with diabetes and hypertension. He had also been diagnosed with cardiomyopathy, although details were unclear. He was referred from local clinics after becoming aware of shortness of breath on exertion. Electrocardiogram showed a 2:1 atrioventriculer block with a wide QRS beat. Echocardiography and cardiac MRI showed very poor left ventricular contraction with chamber dilatation. Echocardiography showed left bundle branch block with dyssynchrony. On the electrophysiological testing, ventricular tachycardia and ventricular fibrillation were not induced, and no significant findings on coronary angiography had revealed at that time. He had shortness of breath on exertion with bradycardia‐tachycardia syndrome and low cardiac function, and his electrophysiological examination was negative. Therefore we decided to implamt cardiac resynchronization therapy pacemaker (CRT‐P). During a guide‐wire insertion for placement of the left ventricular lead into the coronary venous branch, the tip of the guide‐wire suddenly broke off. We attempted to recover the fragment using a snare catheter, but were unsuccessful. Since then the patient has been under observation, with no clinical manifestations seen.