Delayed Right Ventricular Perforation by a Transvenous Active Fixation Implantable Cardioverter-Defibrillator Lead

We report the case of a 51-year-old patient who underwent the implantation of a bi-ventricular implantable cardioverter defibrillator (ICD) complicated by a sub-acute right ventricular minimal perforation with pericardial effusion and echocardiographic signs of tamponade. A new echocardiographic plane orientation allowed us to diagnose this condition in emergency and to make the right decision without delay, which consisting in unscrewing the active fixation screw under fluoroscopy guidance, while the pericardiocentesis was postponed. Thanks to the intervention focused on eliminating the cause of the postcardiac injury syndrome, the patient recovered rapidly and ultimately avoided the pericardiocentesis procedure.

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Asymptomatic right ventricular perforation by an implantable cardioverter defibrillator lead detected by home monitoring system

Journal of Electrocardiology ◽

10.1016/j.jelectrocard.2010.07.022 ◽

2010 ◽

Vol 43 (6) ◽

pp. 673-675 ◽

Cited By ~ 5

Author(s):

Federico Migliore ◽

Loira Leoni ◽

Gianluca Torregrossa ◽

Cosimo Guglielmi ◽

Giuseppe Tarantini ◽

...

Keyword(s):

Right Ventricular ◽

Implantable Cardioverter Defibrillator ◽

Monitoring System ◽

Home Monitoring ◽

Cardioverter Defibrillator ◽

Defibrillator Lead

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Chest Pain Associated with Moderator Band Pacing

Texas Heart Institute Journal ◽

10.14503/thij-13-3602 ◽

2014 ◽

Vol 41 (5) ◽

pp. 551-553 ◽

Cited By ~ 1

Author(s):

Anil K. Goli ◽

Karoly Kaszala ◽

Mohammed N. Osman ◽

John Lucke ◽

Roger Carrillo

Keyword(s):

Chest Pain ◽

Right Ventricular ◽

Implantable Cardioverter Defibrillator ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Lead Extraction ◽

Cardioverter Defibrillator ◽

Moderator Band ◽

Ventricular Lead ◽

Defibrillator Lead

A 65-year-old man was evaluated for chronic chest pain that had been present for 8 years after placement of a dual-chamber implantable cardioverter-defibrillator to treat inducible ventricular tachycardia. Previous coronary angiography had revealed nonobstructive coronary artery disease and a left ventricular ejection fraction of 0.45 to 0.50, consistent with mild idiopathic nonischemic cardiomyopathy. Evaluation with chest radiography and transthoracic echocardiography showed the implantable cardioverter-defibrillator lead to be embedded within the right ventricle at the moderator band, which had mild calcification. Treatment included extraction of the dual-coil lead and placement of a new single-coil right ventricular lead at the mid septum. The patient had complete relief of symptoms after the procedure. This case shows that chest pain can be associated with the placement of a right ventricular implantable cardioverter-defibrillator lead in the moderator band and that symptomatic relief can occur after percutaneous lead extraction and the implantation of a new right ventricular lead to the mid septal region.

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