Late Right Ventricular Perforation After Permanent Pacemaker Implantation: How Far Can the Lead Go?

Abstract

This case report describes the incredible dislocation of a right ventricular lead 1 month after pacemaker implantation. The lead's tip was found in the subcutaneous fat beneath the left breast. Extraction was uneventful. The key steps in the diagnosis and management of this rare complication are discussed.

Very late perforation of an implantable cardioverter defibrillator lead: a case report

“…2,8 Except for late lead perforation, GPs are advised to be aware of other potential complications occurring after the placement of cardiac implantable electronic devices which may include local bleeding or pocket infection, lead dislodgement, or failure with reoccurrence of the symptoms that had led to the pacemaker implantation, subclavian vein thrombosis, or potential lead endocarditis in the presence of fever of unknown origin.…”

Rib Perforation From a Right Ventricular Pacemaker Lead

“…1 Late perforation of pacemaker leads is far less common, with a variety of time frames, symptoms, and clinical findings reported. [2][3][4][5][6][7] The clinical presentation may include extracardiac muscle stimulation, pericardial tamponade, chest pain, or even incidental discovery during an imaging procedure, as in the current case.…”

“The attack of the 52 cm lead”: An unusual case of late cardiac perforation by a passive-fixation permanent pacemaker lead

“…One case report described that too much slack on the ventricular lead could lead to excessive tension leading to perforation [4]. Whether too much slack was involved in our case may be debatable.…”