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Unusual "ratchet syndrome": spontaneous lead retraction after a generator exchange

, : Unusual "ratchet syndrome": spontaneous lead retraction after a generator exchange. Heart and Vessels 29(4): 550-553

A 72-year-old female with idiopathic dilated cardiomyopathy underwent a generator exchange for a cardiac resynchronization therapy defibrillator with a full-pocket capsulectomy. The lead position after the operation was identical to that before the operation on the chest X-ray. After 4 months, a subacute exacerbation of her heart failure was caused by cardiac resynchronization therapy failure due to a dislodgement of the left ventricular lead. An aggressive adhesiotomy of the connective tissue around the leads made it possible for the lead to retract by a ratchet-like movement through the suture sleeve, so-called "ratchet syndrome", after the generator exchange.


PMID: 23846318

DOI: 10.1007/s00380-013-0392-4

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