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{
    "pk": 53214,
    "title": "Emergency Department Transvenous Pacemaker Placement Complicated by Tricuspid Mass",
    "subtitle": null,
    "abstract": "<p><strong>Case Presentation: </strong>Temporary transvenous pacemaker placement is frequently performed in the emergency department for the management of symptomatic bradyarrhythmias. We report the case of a 93-year-old male who presented with profound bradycardia, hypotension, and altered mental status requiring emergent pacing. Initial transcutaneous pacing achieved hemodynamic improvement but necessitated escalation to transvenous pacing due to patient discomfort and high current requirements. During attempted transvenous pacemaker placement, resistance was encountered and capture could not be achieved despite appropriate technique. Subsequent cardiology consultation and imaging revealed an undiagnosed tricuspid valve myxoma obstructing catheter advancement.</p>\n<p><strong>Discussion</strong>: This case highlights a rare mechanical complication of transvenous pacemaker placement caused by an intracardiac mass. Awareness of structural cardiac pathology as a potential cause of pacemaker placement failure is critical, particularly when resistance is encountered despite correct procedural technique</p>",
    "language": "eng",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "transvenous pacemaker"
        },
        {
            "word": "cardiac myxoma"
        },
        {
            "word": "bradycardia"
        },
        {
            "word": "emergency pacing"
        }
    ],
    "section": "Images in Emergency Medicine",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/22j4p7w7",
    "frozenauthors": [
        {
            "first_name": "Kevin",
            "middle_name": "",
            "last_name": "Molyneux",
            "name_suffix": "",
            "institution": "Columbia University, Department of Emergency Medicine, New York, New York; Texas Tech University Health Sciences Center of El Paso, Department of Emergency Medicine, El Paso, Texas",
            "department": ""
        },
        {
            "first_name": "Nicholas",
            "middle_name": "",
            "last_name": "Krejchi",
            "name_suffix": "",
            "institution": "Texas Tech University Health Sciences Center of El Paso, Department of Emergency Medicine, El Paso, Texas",
            "department": ""
        },
        {
            "first_name": "Matthew",
            "middle_name": "Robert",
            "last_name": "Fulton II",
            "name_suffix": "",
            "institution": "Texas Tech University Health Sciences Center of El Paso, Department of Emergency Medicine, El Paso, Texas",
            "department": ""
        },
        {
            "first_name": "Mina",
            "middle_name": "",
            "last_name": "Youssef",
            "name_suffix": "",
            "institution": "Texas Tech University Health Sciences Center of El Paso, Department of Cardiology, El Paso, Texas",
            "department": ""
        }
    ],
    "date_submitted": "2025-10-20T20:39:05.168000-04:00",
    "date_accepted": "2026-01-22T17:30:24.182000-05:00",
    "date_published": "2026-05-24T01:18:00-04:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "PDF",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/53214/galley/50482/download/"
        }
    ]
}