Right ventricular perforation by a passive-fixation pacemaker lead two weeks after implantation

• Main Authors: Azeem S. Sheikh, BSc, MBBS, FCPS, MRCP, Farazin Hosseini-Ardehali, Sajjad Mazhar, MBBS, MRCP
• Format: Article
• Language: English
• Published: Wiley 2014-12-01
• Series: Journal of Arrhythmia
• Subjects: Ventricular perforation; Permanent pacemaker; Lead perforation; Passive-fixation lead; Cardiac pacemaker
• Online Access: http://www.sciencedirect.com/science/article/pii/S1880427614000428

Myocardial perforation is a rare complication of permanent pacemaker implantation. While most of the perforations occur at the time of implantation or within the first 24 h, delayed myocardial perforations are very rare. The clinical course is extremely variable with some patients presenting completely asymptomatic, while others can develop cardiac tamponade and haemodynamic instability. We report an unusual case of a subacute ventricular perforation caused by a passive-fixation lead two weeks after implantation and we successfully managed to extract the lead under local anaesthesia, without the patient undergoing surgery, as recommended in the previously published reports.