Delayed cardiac tamponade after pacemaker insertion

Gershon, Terri; Kuruppu, Janaki; Olshaker, Jonathan S.

doi:10.1016/s0736-4679(99)00228-0

Cited by 22 publications

(8 citation statements)

References 10 publications

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“…Postcardiac injury syndrome and stroke following PPI is also known [2]. Pneumothorax as a complication of vascular access during cardiac interventions have been reported [3].The management of accidental and iatrogenic foreign body injuries to heart should be managed on priority as foreign bodies may manifest with infection, arrhythmia, or neurotic complications like cardiac tamponade [4].Life threatening complications of like cardiac tamponade is a surgical emergency and urgent surgery is the only mode of therapy in these individuals [5].In a largescale, real-world experience of PPI in developed countries, the results indicate an increase in the incidence of in-hospital tamponade [6].Cardiac tamponade can occur secondary to perforation of the right ventricle during pacemaker electrode insertion and manipulation [7].Cardiac perforation usually occur more common through right ventricular apex as it is relatively thinner than the other implantable sites like septum or right ventricular outflow tract [8]. Low body mass index, age more than eighty years and prolonged use of steroids are the risk factors of cardiac chamber perforation [8].…”

Section: Discussionmentioning

confidence: 99%

Cardiac tamponade with pneumothorax- An unusual life threatening complication following permanent pacemaker implantation.

Kumar¹,

Rawat²,

Halder³

et al. 2020

Preprint

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Permanent pacemaker implantation is life saving but sometimes the procedure may itself become life threatening. Right ventricular perforation is a rare complication during pacemaker insertion that could be life-threatening and need immediate intervention. Chest X-ray, echocardiogram and computer tomogram of chest are used to diagnose lead migration and its complications. We present a rarest of the rare case in which a seventy six year old patient undergoing permanent pacemaker implantation suffered both iatrogenic cardiac injury leading to hemopericardium and pacemaker malfunction as well as injury to left pleura leading to massive pneumothorax and hemodynamic instability which was managed successfully.

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Section: Discussionmentioning

confidence: 99%

Cardiac tamponade with pneumothorax- An unusual life threatening complication following permanent pacemaker implantation.

Kumar¹,

Rawat²,

Halder³

et al. 2020

Preprint

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“…If cardiac tamponade occurred, consequently it will be presented as palpitation, dyspnea, cyanosis and agitation. 11 The key issue of management of cardiac perforation caused by pacing lead is whether perforated lead needs treatment and if so, how. Currently, there are not adequate proofs as to which strategy is best.…”

Section: Discussionmentioning

confidence: 99%

A Case of Delayed Cardiac Perforation of Active Ventricular Lead

Guo

Xing

2011

Clinics and Practice

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A 65-year-old man was admitted as for one month of repetitive dizziness and one episode of syncope. Electrocardiogram showed sinus bradycardia and his Holter monitoring also showed sinus bradycardia with sinus arrest, sino-atrial block and a longest pause of 4.3 s. Then sick sinus syndrome and Adam-Stokes syndrome were diagnosed. Then a dual chamber pacemaker (Medtronic SDR303) was implanted and the parameters were normal by detection. The patient was discharged 1 week later with suture removed. Then 1.5 month late the patient was presented to hospital once again for sudden onset of chest pain with exacerbation after taking deep breath. Pacemaker programming showed both pacing and sensing abnormality with threshold of > 5.0V and resistance of 1200Ω. Lead perforation was revealed by chest X-ray and confirmed by echocardiogram. Considering the fact that there was high risk to remove ventricular lead, spiral tip of previous ventricular lead was withdrew followed by implantation of a new ventricular active lead to the septum. Previous ventricular lead was maintained. As we know that the complications of lead perforation in the clinic was rare. Here we discuss the clinical management and the possible reasons for cardiac perforation of active ventricular lead.

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“…Permanent PM implantation may be complicated by cardiac perforation, which can lead to longer hospital stays, tamponade, or even death (Aizawa et al, 2001;Ellenbogen et al, 2002;Garcia-Bolao et al, 2001;Gershon et al 2000). The incidence of perforation after permanent PM reportedly is between 0.5% and 2%, but the predictors of perforation have not been defined (Hill, 1987;Sivakumaran et al, 2002).…”

Section: Lead-related Complicationsmentioning

confidence: 99%