Residual fibrous tissue floating in the right atrium after percutaneous pacemaker lead extraction: An unusual complication early detected by intracardiac echocardiography

Extraction of pacemaker leads represents the optimal therapy in patients with endocarditis involving the pacemaker leads. The percutaneous approach is becoming popular. However, complications of percutaneous extraction are not rare and incomplete removal of the vegetations with embolization in the pulmonary arteries has been described. This case report describes for the first time a case of incomplete removal of the fibrous sheath covering the lead, with residual tissue floating in the right atrium after pacemaker/ICD extraction. ICE monitoring was essential for early detection and correct diagnosis of this complication.