Perforation of right ventricular free wall by pacemaker lead detected by multidetector computed tomography

Abstract

Pacemaker lead perforation is a recognized complication of lead implantation, particularly with active fixation leads. Multidetector computed tomography (MDCT) is emerging as the imaging modality of choice in diagnosing lead perforation, identifying associated sequelae such as pericardial effusion and planning extraction. We present a case illustrating the use of MDCT in a case of right ventricular (RV) lead perforation manifesting 5 days after cardiac resynchronization therapy pacing.

Perforation of the right ventricle during cardiac resynchronisation therapy upgrade not related to a coexisting persistent left superior vena cava

“…Moreover, no electrodes were placed via the LSVC. MDCT has become the imaging modality of choice for the detection of lead perforation 1. In our patient it has allowed us to carefully plan the extraction that was accomplished by simple traction and rescrewing of the electrode into a new location, with no complications.…”

Late cardiac perforation: a persistent risk of cardiac implantable device leads

“…Simple imaging studies such as chest x-ray (CXR) and echocardiography may help in reaching a provisional diagnosis. For delineation of anatomy, the presence of adverse sequel and precise location of perforated lead tip, a CT scan of chest is necessary [4,5,38]. Although CXR, ECG and CT scan chest appeared to be normal in the case reported by Velavan [34], CT chest has been established as the gold standard for diagnosis.…”

Near-fatal Outcome of Late Cardiac Perforation by a Pacemaker Lead in a Young Woman with Transposition of the Great Arteries

“…Delayed lead perforations are believed to be very rare but have been reported in several case reports 1,5–9 . When occurring, they are often characterized by a low rate of tamponade and no cases of death have been documented 1,2 .…”