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

This report illustrates an unusual case of asymptomatic late cardiac perforation by an atrial pacemaker lead into the right lung. In the present case, the lead was explanted by simple manual traction through the device pocket without any complications.

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Positional syncope occurring just at the right time in a patient with a permanent pacemaker: a case report

Journal of the Pakistan Medical Association ◽

10.47391/jpma.06-844 ◽

2021 ◽

Vol 71 (10) ◽

pp. 2461-2463

Author(s):

Syed Haseeb Raza Naqvi ◽

Madiha Fatima ◽

Pir Sheeraz Ali ◽

Maqsood Alam ◽

Muhammad Taha Khan ◽

...

Keyword(s):

Case Report ◽

Hospital Admission ◽

Unusual Case ◽

Pacemaker Implantation ◽

Integrated Approach ◽

Permanent Pacemaker ◽

Pacemaker Lead ◽

History Taking ◽

Lead Fracture ◽

The Right

We present an unusual case of positional syncope occurring years after pacemaker implantation due to pacemaker lead fracture resulting from subclavian-crush syndrome. The syncope occurred incidentally during hospital admission and was timely diagnosed using an integrated approach of history taking, examination findings, device interrogation and radiographic parameters. The patient subsequently underwent lead and device revision which led to resolution of her symptoms. Continuous...

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A rare case of late right ventricular perforation by a passive-fixation permanent pacemaker lead

EP Europace ◽

10.1093/europace/eup120 ◽

2009 ◽

Vol 11 (7) ◽

pp. 968-969 ◽

Cited By ~ 13

Author(s):

D. Tziakas ◽

A. Alexoudis ◽

F. Konstantinou ◽

G. Chalikias ◽

D. Stakos ◽

...

Keyword(s):

Right Ventricular ◽

Rare Case ◽

Permanent Pacemaker ◽

Pacemaker Lead ◽

Passive Fixation

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Chest pain following permanent pacemaker insertion… a case of pneumopericardium due to atrial lead perforation

BMJ Case Reports ◽

10.1136/bcr-2018-226318 ◽

2018 ◽

pp. bcr-2018-226318 ◽

Cited By ~ 1

Author(s):

Suleman Aktaa ◽

Kavi Fatania ◽

Claire Gains ◽

Hazel White

Keyword(s):

Chest Pain ◽

Ct Scan ◽

Permanent Pacemaker ◽

Common Procedure ◽

Cardiac Perforation ◽

Lead Perforation ◽

Repeat Chest ◽

Normal Chest ◽

Chest X Ray ◽

Pacemaker Insertion

Permanent pacemaker (PPM) implantation is an increasingly common procedure with complication rate estimated between 3% and 6%. Cardiac perforation by pacemaker lead(s) is rare, but a previous study has shown that it is probably an underdiagnosed complication. We are presenting a case of a patient who presented 5 days after PPM insertion with new-onset pleuritic chest pain. She had a normal chest X-ray (CXR), and acceptable pacing checks. However, a CT scan of the chest showed pneumopericardium and pneumothorax secondary to atrial lead perforation. The pain only settled by replacing the atrial lead. A repeat chest CT scan a few months later showed complete resolution of the pneumopericardium and pneumothorax. We believe that cardiac perforation can be easily missed if associated with normal CXR and acceptable pacing parameters. Unexplained chest pain following PPM insertion might be the only clue for such complication, although it might not always be present.

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