Abstract
We present a case of air embolism during biventricular defibrillator implantation in a 58-year-old man with pulmonary fibrosis. To prevent air entry after the dilator was removed, the subclavian venous sheath was covered before the lead was introduced. Air embolism occurred during inspiration around the lead body in the appropriate sized sheath but without a hemostatic valve. Extraordinary swings in intrathoracic pressure due to noncompliant lungs may have contributed to this unusual complication.
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