Complete pacemaker lead fracture potentially due to intra-cardiac mass

Seven years after the implantation of a dual-chamber pacemaker, a 74-year-old woman was referred for syncope. Chest X-ray revealed that the ventricular lead was completely broken near the tricuspid valve. Fluoroscopy and transthoracic echocardiography found a calcified mass, moving with the proximal part of the ventricular lead. Anatomopathology of the atrial tumour remained unknown. Surgery was considered too invasive a technique to be performed in our patient, who was suffering from dementia.