We report a case of ventricular perforation by an active-fixation permanent pacemaker lead in a young woman with congenital heart defect and pacemaker because of atrioventricular block. The rarity of the case is based not only upon the late perforation (as opposed to the more common acute perforations) but also on the near-fatal outcome. The patient experienced sharp chest pain and 1 week later passed out with cardiac arrest.
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