Clinical observation of the formation of fat particles and fat liquefaction in a CIED pocket: A case report

Abstract

Abstract Background The number of implanted cardiovascular implantable electronic devices (CIEDs) has increased significantly in recent years, which has led to an upsurge in CIED complications, such as infection and lead malfunction requiring CIED extraction. Few cases of fat liquefaction and fat particles in the CIED pocket have been reported. And no pathological diagnosis was found.Case presentation A 71-year-old Chinese woman presented with Pacemaker failure and asthma. Fat liquefaction and fat particles in the pacemaker pocket were found during the replacement procedure. The patient had no symptoms and no signs of infection or other discomfort of the heart and pacemaker pocket. Thick yellow liquid was seen to flow out of the pacemaker pocket when the pocket was opened, and many fat particles were found adhering to the wall of the pacemaker pocket during the pacemaker replacement procedure. Fat and fibrillar connective tissue with a few inflammatory cells, local tissue degeneration and necrosis were shown on immunohistochemical staining and no bacterial growth including anaerobic bacteria was observed. No redness, swelling, fever, or wound pain were observed during the nine-month follow-up period.Conclusion The presence of fat liquefaction and fat particles in a CIED pocket may be related to the necrosis of fat cells.