Bow-and-arrow sign on point-of-care ultrasound for diagnosis of pacemaker lead-induced heart perforation: A case report and literature review

Table 2 Cases of right ventricular apex perforation by lead diagnosed using ultrasonography

Ref.	Age (yr)/Sex	Types of perforation	Pericardial effusion	Lead passing through RV wall	Lead tip location	Features on ultrasound
Vasavada et al[22], 2014	58/NM	Chronic	Positive	Positive	Pericardial space	Lead passing through the myocardium like a “spear”
Shen et al[23], 2006	97/Woman	Chronic	Positive	Positive	At the perforation	3-D echo enhancing visualization of the pseudoaneurysm by lead
Stefanidis et al[24], 2009	83/Woman	Subacute	Positive	Positive	Pericardial space	3-D echo confirming the lead perforation
Truscelli et al[25], 2011	68/Man	Acute	Positive	Positive	Pericardial space	Lead protrusion through myocardium of RV
Boxma et al[26], 2017	77/Woman	Subacute	Negative	Positive	Pericardial space	Absence of pericardial effusion
Allouche et al[27], 2021	85/Woman	Subacute	Negative	Positive	Pericardial space	Absence of pericardial effusion
Abdelhafez et al[28], 2018	41/Woman	Acute	Positive	Positive	NM	NM
Ferrero-de-Loma-Osorio et al[29], 2009	27/Woman	Chronic	Positive	Positive	Pericardial space	Lead going in and out of RV with each cardiac movement
Ramirez et al[30], 2007	68/Man	Chronic	Negative	Positive	NM	Absence of pericardial effusion
Addison et al[31], 2015	65/Man	Chronic	Positive	Positive	Pericardial space	NM
Hardzina et al[32], 2014	26/Woman	Chronic	Positive	Positive	Pericardial space	NM
Trehan et al[33], 2005	80/Woman	Acute	Positive	Positive	Pericardial space	NM
Velibey et al[34], 2017	92/Woman	Subacute	Positive	Positive	Pericardial space	NM
Chen and Ho[35], 2022	73/Man	Subacute	Positive	Positive	NM	Discontinuation of RV free wall
Sugano et al[36], 2012	73/Man	Acute	Positive	Positive	Pericardial space	3-D echo confirming the lead perforation
Vandenberk et al[37], 2022	81/Man	Chronic	Positive	Positive	Epicardial fat	Lead projecting in the epicardial fat
Caiati et al[38], 2020	51/Man	Subacute	Positive	Positive	Pericardial space	Showing characteristics of the fixating screw and the electrode
Noguchi et al[39], 2017	62/Woman	Subacute	Positive	Positive	Pericardial space	NM
Nash et al[40], 2014	77/Woman	Acute	Positive	NM	Pericardial space	An echo bright structure within the pericardial effusion
Madanat et al[18], 2022	77/Woman	Chronic	Negative	Positive	Pericardial space	TEE showing the lead perforating through the apex
Velasco et al[41], 2014	90/Man	Chronic	Positive	Positive	Pericardial space	NM
Kourireche et al[42], 2017	47/Woman	Chronic	Positive	Positive	Pericardial space	NM

RV: Right ventricle; NM: Not mentioned; 3-D: Three-dimensional; TEE: Transesophageal echocardiography.