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World J Clin Cases. Jun 16, 2014; 2(6): 206-208
Published online Jun 16, 2014. doi: 10.12998/wjcc.v2.i6.206
Published online Jun 16, 2014. doi: 10.12998/wjcc.v2.i6.206
Case of early right ventricular pacing lead perforation and review of the literature
Gary Nash, John Mark Williams, Rajasekhar Nekkanti, Assad Movahed, Department of Cardiovascular Sciences, East Carolina University, Brody School of Medicine, East Carolina Heart Institute, Greenville, NC 27858, United States
Author contributions: Nash G, Williams JM, Nekkanti R and Movahed A contributed to the manuscript writing and revision.
Supported by “East Carolina Heart Institute”
Correspondence to: Assad Movahed, MD, Department of Cardiovascular Sciences, East Carolina University, Brody School of Medicine, East Carolina Heart Institute, 115 Heart Drive, Mail Stop 651, Greenville, NC 27834, United States. movaheda@ecu.edu
Telephone: +1-252-7444400 Fax: +1-252-7447724
Received: November 19, 2013
Revised: March 6, 2014
Accepted: May 8, 2014
Published online: June 16, 2014
Revised: March 6, 2014
Accepted: May 8, 2014
Published online: June 16, 2014
Abstract
We report a case of a 77-year-old patient with complete atrioventricular block. She underwent permanent pacemaker implantation complicated by right ventricular lead perforation. This was suspected on transthoracic echocardiogram and confirmed by chest computed tomography. The lead was repositioned in the cardiac electrophysiology lab followed by an uneventful course thereafter.
Keywords: Pacemaker, Lead, Perforation
Core tip: Cardiac perforation should be considered in cases of pacing lead malfunction. Chest computed tomography is helpful in diagnosing lead perforation and can be done without contrast and using a small field of view to diminish the effective radiation dose.