You are caring for a patient who has an open left-sided forearm fracture with nerve and vascular injury. He has dementia and is unable to provide a meaningful history. On physical examination, you note a surgical scar plus a palpable round mass under the skin just inferior to the left clavicle. The anterior-posterior and lateral chest radiographs to the right are obtained. The patient came with no other history or documents. What is MOST likely the identity of this device?
In this scenario, before the chest radiographs were obtained, it was clear that the patient most likely had a pacemaker device that may or may not have been capable of internal cardiac defibrillation (ICD) or cardioversion. A chest radiograph showed it to have two leads, one terminating in the right atrium and the other in the right ventricle. There are two bright and thickened areas on the right ventricular lead...