Paciente feminina, 40 anos, portadora de marcapasso artificial defintivo há 1 semana. Realiza ecocardiograma transtorácico durante internamento hospitalar. Encontra-se em ritmo sinusal e não apresenta disfunção sistólica dos ventrículos direito e esquerdo. Não apresenta febre, leucocitose ou qualquer sinal de infecção.
Conforme a literatura:
Transesophageal echocardiography in the diagnosis of thrombosis associated with permanent transvenous pacemaker electrodes. Pacing Clin Electrophysiol. 2006; 29(11):1245-50
TEE is an excellent method to visualize electrodes within the RA and proximal SVC. Electrode-associated RA thrombi appear to be relatively common after PM implantation, and they may remain undetectable by venography or TTE. Although these thrombi are mostly asymptomatic, they can give rise to pulmonary embolism and should also be kept in mind in the differential diagnosis of endocarditis. TEE is the method of choice for the diagnosis of these lesions.
Intra-atrial thrombosis and pulmonary embolism complicating pacemaker leads for cardiac resynchronization therapy. J Interv Card Electrophysiol. 2003; 9(1):25-7
This report suggests that long-term oral anticoagulation should be considered in patients with depressed left ventricular function undergoing cardiac resynchronization therapy in order to prevent this potentially serious complication.
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