The Pacemaker Cable as an Unexpected Cause of Recurrent Pulmonary Embolism
Year: 2026
Type: article
Study design: Case Report
Abstract: Recurrent pulmonary embolism (PE) is uncommon. We report a 39-year-old man with a pacemaker who developed recurrent PEs while receiving rivaroxaban, warfarin, and therapeutic enoxaparin. Evaluation for autoimmunity and thrombophilia was negative. Each episode was preceded by fever, malaise, and myalgia. During admission, 18-fluorodeoxyglucose positron emission tomography–computed tomography (18FDG PET/CT) showed focal uptake (maximum standardized uptake value, 2.3) along the right-ventricular pacemaker lead, suggesting device-related infection or thrombosis. Transvenous extraction failed; subsequently, surgical removal was performed. Cultures remained negative. This case highlights pacemaker-associated infection as a treatable cause of septic embolization and underscores the diagnostic value of 18FDG PET/CT in recurrent PE.
Institutions: Universidade de São Paulo, Instituto do Coração - HCFMUSP
Language: English
Subfield: Internal Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7129600579