Thorac Cardiovasc Surg 2009; 57(3): 176-177
DOI: 10.1055/s-2008-1038705
Short Communications

© Georg Thieme Verlag KG Stuttgart · New York

Late Perforation of a Right Ventricular Pacing Lead: A Potentially Dangerous Complication

T. Schroeter1 , N. Doll1 , M. A. Borger1 , H. V. Groesdonk2 , D. R. Merk1 , F. W. Mohr1
  • 1Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
  • 2Department of Anesthesiology, Heart Center Leipzig, Leipzig, Germany
Further Information

Publication History

received April 17, 2008

Publication Date:
27 March 2009 (online)

Abstract

Four days after uncomplicated implantation of a two-chamber pacemaker and a normal postoperative course, a patient was referred to our hospital with left-sided hemothorax and early hemorrhagic shock. Chest X‐ray and CT scan were suspicious of a right ventricular lead perforation with additional pericardial and pleural injury. Immediate surgery was performed via a lateral thoracotomy and the perforation was repaired via direct suture. An epimyocardial ventricular lead was implanted simultaneously. The patient made an uneventful recovery.

References

  • 1 Ellenbogen K A, Wood M A, Shepard R K. Delayed complications following pacemaker implantation.  PACE. 2002;  25 1155-1158
  • 2 Burney K, Burchard F, Papouchado M, Wilde P. Cardiac pacing systems and implantable cardiac defibrillators (ICDs): a radiological perspective of equipment, anatomy and complications.  Clin Radiol. 2004;  59 699-708
  • 3 Khan M, Joseph G, Khaykin Y, Ziada K, Wilkoff B. Delayed lead perforation: a disturbing trend.  PACE. 2005;  28 251-253
  • 4 Polin G M, Zado E, Nya K, Cooper J M, Russo A M, Dixit S, Lin O. et al . Proper management of pericardial tamponade as a late complication of implantable cardiac device placement.  Am J Cardiol. 2006;  15 223-225
  • 5 Hirschl D A, Jain V R, Spindola-Franco H, Gross J N, Haramati L B. Prevalence and characterization of asymptomatic pacemaker and ICD lead perforation on CT.  PACE. 2007;  30 28-32
  • 6 Ishikawa K, Cida K, Taniguchi T. Myocardial perforation and/or penetration by a permanent endocardial electrode of the pacemaker in autopsy cases.  J Arrhythmia. 1999;  15 29-44
  • 7 Greenberg S, Lawton J, Chen J. Right ventricular lead perforation presenting as left chest wall muscle stimulation.  Circulation. 2004;  111 e451-e452
  • 8 Dilling-Boer D, Ector H, Willems R, Heidbüchel H. Pericardial effusion and right-sided pneumothroax resulting from an atrial active-fixation lead.  Europace. 2003;  5 419-423
  • 9 Wan-Jing H, Chi-Tai K, Kuo-Hong L. Right pneumothorax resulting from an endocardial screw-in atrial lead.  Chest. 1999;  116 1133-1134
  • 10 Oginosawa Y, Abe H, Nakashima Y. Right pneumothorax resulting from an endocardial screw-in atrial lead in an implantable cardioverter defibrillator system.  Pacing Clin Electrophysiol. 2002;  25 1278-1279

MD Thomas Schroeter

Heart Center Leipzig
Department of Cardiac Surgery

Struempellstrasse 38

04155 Leipzig

Germany

Phone: + 49 (0) 3 41 86 50

Email: thomas-schroeter@gmx.de