Worsening heart failure as the main manifestation of neglected complete extrusion of a cardiac resynchronization therapy pacemaker

Abstract

A patient with dilated cardiomyopathy presented at the emergency department with a completely extruded cardiac resynchronization therapy pacemaker, complaining of worsening dyspnea. The device was functioning intermittently, and no evidence of local or systemic inflammation was observed. The patient had been living with the device hanging against his chest for several weeks and he eventually sought medical assistance because of worsening heart failure. The device and leads were extracted, but the patient refused a new implantation at the contralateral site.