Article Details

Cardiac implantable electronic devices (CIEDs) have become a cornerstone in the management of bradyarrhythmias, heart failure, and other conduction system disorders. Device removal, though less frequent than implantation, is often required for infection, malfunction, or system upgrades.
Among these complications, CIED-related infections-particularly infective endocarditis-pose a significant risk, especially in older adults. Early identification and prompt multidisciplinary intervention are essential for optimizing outcomes in this population, where care often requires coordination between electrophysiologists, infectious disease specialists, and primary care providers.
Historically, early pacemaker implantation was performed through surgical cutdown of venous access, most commonly via the cephalic vein and, in certain cases, through the external jugular vein, before modern techniques using the subclavian and axillary veins became standard.
This case highlights the incidental detection of a dual-fractured endocardial pacemaker electrode nearly a decade after removal, emphasizing the importance of recognizing retained hardware and its implications in modern clinical care.