Delayed cardiac tamponade by iatrogenic aortic perforation with pacemaker implantation

Sticco, Charles C.; Barrett, Leonard O.

doi:10.1016/j.jtcvs.2005.08.060

Cited by 10 publications

(6 citation statements)

References 5 publications

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“…1 Aortic perforation by a pacemaker lead is extremely uncommon. 2,3 Our patient had no symptoms until he collapsed during his weekly bridge game 2 weeks after the pacemaker implantation. The sudden onset of chest pain combined with circulatory collapse and a large amount of blood in the pericardium and around the ascending aorta advocated for a type A aortic dissection.…”

Section: Discussionmentioning

confidence: 77%

Aortic perforation with cardiac tamponade two weeks after pacemaker implantation

Kaljusto

Tønnessen

2007

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussionmentioning

confidence: 77%

Aortic perforation with cardiac tamponade two weeks after pacemaker implantation

Kaljusto

Tønnessen

2007

The Journal of Thoracic and Cardiovascular Surgery

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“…Should delayed lead perforation become symptomatic, pleuritic or pericarditis chest pain has been reported in most cases 3 . However, the clinical presentation can be very manifold, ranging from hiccups, diaphragmatic pacing, angina with ST‐segment elevations to hemodynamic instability 9–12 . Regarding the electrical performance of the device, loss of capture or drastic increase in stimulus threshold usually associated with undersensing are the main malfunctions in this context 3,7,13 .…”

Section: Discussionmentioning

confidence: 99%

“… 3 However, the clinical presentation can be very manifold, ranging from hiccups, diaphragmatic pacing, angina with ST‐segment elevations to hemodynamic instability. 9 , 10 , 11 , 12 Regarding the electrical performance of the device, loss of capture or drastic increase in stimulus threshold usually associated with undersensing are the main malfunctions in this context. 3 , 7 , 13 While risk factors for symptomatic lead perforation such as steroid and anticoagulant use, screw‐in leads, older age, and BMI <20 kg/m 2 have been identified, 14 an understanding of the specific mechanism of perforation remains subject to speculation.…”

Section: Discussionmentioning

confidence: 99%

Delayed perforation of an atrial pacemaker electrode: Lifelong risk for a rare but serious complication

Waechter

König

Chatzis

et al. 2023

Clinical Case Reports

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Key Clinical Message Nonspecific symptoms such as pleuritic or pericardial chest pain in cardiovascular implantable electronic devices patients, even with unremarkable ECG or device parameters, should always raise suspicion of electrode perforation, regardless of how long ago the implantation was performed. Abstract We report the successful percutaneous management of a 77‐year‐old woman who had a dual‐chamber pacemaker implanted more than 1 year ago and presented with pericarditis pain and compensated pericardial hemorrhagic tamponade. The symptoms were due to very late acute perforation of the atrial lead. This report is intended to raise awareness of procedure‐related complications in the large group of cardiovascular implantable electronic device patients. Pleuritic or pericardial pain in these patients should raise suspicion of electrode perforation, as the risk of perforation is not restricted to the period immediately after implantation and a lifelong risk cannot apparently be excluded.

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“…At this point, the active lead, positioned inside the aorta like a cork, slipped out, causing cardiac tamponade. In a review of relevant literature, we identified only five cases [1–5] of atrial damage by a pacemaker lead with concomitant aortic wall perforation, as shown in Table 1. However, not all reports indicate whether the lead responsible for the cardiac laceration was active or passive.…”

Section: Discussionmentioning

confidence: 99%

Aortic perforation due to cardiac resynchronisation therapy defibrillator lead placement: Case report and medicolegal considerations

Grande

Fiore

Merlano

et al. 2015

Journal of Arrhythmia

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A 45-year-old woman with dilated cardiomyopathy was admitted for the upgrade of a previously implanted pacemaker. Echocardiography showed intraventricular dyssynchrony and a low ejection fraction (0.35). Treatment with a cardiac resynchronization therapy defibrillator (CRT-D) was selected and the device was implanted. CRT-D interrogation revealed proper function. Following procedure termination, the patient went into cardiac arrest and died despite resuscitation attempts. An autopsy revealed that the medial aspect of the right atrium was pierced by an active lead and that the aorta had a deep lesion, 2 mm in length, on its lateral aspect. We explain the probable pathogenesis of this patient׳s death.

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Delayed cardiac tamponade by iatrogenic aortic perforation with pacemaker implantation

Cited by 10 publications

References 5 publications

Aortic perforation with cardiac tamponade two weeks after pacemaker implantation

Aortic perforation with cardiac tamponade two weeks after pacemaker implantation

Delayed perforation of an atrial pacemaker electrode: Lifelong risk for a rare but serious complication

Aortic perforation due to cardiac resynchronisation therapy defibrillator lead placement: Case report and medicolegal considerations

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