Computed Tomography to Assess Possible Cardiac Lead Perforation

Henrikson, Charles A.; Leng, Charles T.; Yuh, David D.; Brinker, Jeffrey A.

doi:10.1111/j.1540-8159.2006.00385.x

Cited by 67 publications

(52 citation statements)

References 9 publications

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“…Computed tomography scan proves very valuable when echocardiography and X-ray test are not diagnostic. Consequently, CT scan is currently a gold standard in the diagnosis of lead perforations [14], even though the technique also has its limitations. The star artifact is a well-known artifact related to the imaging of metal implants.…”

Section: Discussionmentioning

confidence: 99%

Life Threatening Perforation of Pacemaker Atrial Lead through the Right Atrium and the Right Lung

2015

JCCR

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We report the case of a 65-year old female patient who was urgently admitted to our institution with hemothorax after pacemaker implantation. The bichamber pacemaker had been implanted one week before admission and the active fixation lead caused perforation of the right atrial wall and penetration of the right lung. Transthoracic echocardiography demonstrated a minimal cardiac effusion but chest X-Ray and computed Tomography (CT) visualised the atrial screw helix outside the atrial wall penetrating through the right lung middle lobe causing hemothorax. After median sternotomy and cut-off of the atrial lead screw helix, we sew the perforated area of the right atrium and the penetrated right lung, sucking away the bloody pleural effusion before closing the thorax. Three weeks later, the cut off atrial lead was extracted through the right subclavian vein and a new one was positioned and fixed again. During the hospital admission the patient was well and free of any symptoms and troubles.

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Section: Discussionmentioning

confidence: 99%

Life Threatening Perforation of Pacemaker Atrial Lead through the Right Atrium and the Right Lung

2015

JCCR

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“…However, it occasionally fails to demonstrate such findings. CT scan, especially with multi-detector scanners using cardiac protocols, can be useful when other modalities are nondiagnostic (Henrikson et al, 2006). Thus CT scan is becoming the gold standard in diagnosis of cardiac perforation and lead tip visualization.…”

Section: Diagnosismentioning

confidence: 99%

Cardiac Perforation Associated with a Pacemaker or ICD Lead

Oh¹

2011

Modern Pacemakers - Present and Future

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“…Predictors with a lower perforation potential included, a pulmonary artery pressure >35 mm Hg (probable protective effect of hypertrophied RV) and BMI>30 (univariate predictor only). Interestingly, steroid use is associated with cardiac atrophy, mediated by a muscle specific protein called muscle ring finger-1 [30].…”

Section: Patient Risk Factors and Risk For Perforationmentioning

confidence: 99%

“…Patients can be observed and watched for lead migration and at that point lead extraction could be performed. [16,30,31] Simple lead positioning can be utilized in some cases especially in acute or early stages when minimal fibrotic adhesions facilitate repositioning. [32] If there is bleeding within or outside of the mediastinum, accompanied by lung or other vascular damage, especially if the lead was recently implanted, the lead should be explanted surgically to insure adequate surgical correction of the problem.…”

Section: Management Of Lead Perforationmentioning

confidence: 99%