It was reported in a journal article that the patient underwent a 3-vessel coronary artery bypass grafting/cabg procedure in 1999 and the epicardial temporary pacing wire was placed.Three years after, in 2002 the patient experienced ventricular tachycardia and presented with respiratory distress that progressed to full cardiopulmonary arrest requiring intubation.Monomorphic ventricular tachycardia was documented at presentation and the patient was successfully cardioverted to sinus rhythm.The patient was extubated the following day.On day 4 of hospitalization, the patient experienced an episode of near syncope associated with palpitations and was transferred for further evaluation.A transesophageal echocardiogram noted a wire passing through the right atrium, right ventricle, and into the pulmonary artery.Fluoroscopy revealed epicardial temporary pacing wires retained from his cabg operation in 1999 and a wire of the same caliber that appeared to course through the right ventricular outflow tract into the pulmonary artery.The intracardiac position and course of the wire were confirmed with a chest computed tomography scan.The unipolar epicardial pacing wire was extracted and non-sustained monomorphic vt occurred during wire manipulation.Because of the patient¿s left ventricular dysfunction, he was still considered to be at high risk for sudden cardiac death and underwent successful defibrillator implantation.The patient has done well, with no palpitations since discharge.Additional information has been requested.
|