Lead perforation is a rare complication of device implantation, varying between 0.3% and 1%, although the prevalence may be higher. Late lead perforations (>1 month after implantation) are believed to be very rare. We describe the successful treatment of a 65-year-old man with late cardiac perforation due to the pacemaker active fixation lead after an uneventful implantation.
HirschlDAJainVRSpindola-FrancoH. Prevalence and characterization of asymptomatic pacemaker and ICD lead perforation on CT. Pacing Clin Electrophysiol2007; 30: 28–32.
2.
KayGNBrinkerJAKawanishiDT. Risks of spontaneous injury and extraction of an active fixation pacemaker lead: report of the Accufix Multicenter Clinical Study and Worldwide Registry. Circulation1999; 100: 2344–2352.
3.
ConnollySJKerrCRGentM. Effects of physiologic pacing versus ventricular pacing on the risk of stroke and death due to cardiovascular causes. Canadian Trial of Physiologic Pacing Investigators. N Engl J Med2000; 342: 1385–1391.
4.
SivakumaranSIrwinMEGulamhuseinSS. Postpacemaker implant pericarditis: incidence and outcomes with active-fixation leads. Pacing Clin Electrophysiol2002; 25: 833–837.
5.
TriganoAJTaramascoVPaganelliF. Incidence of perforation and other mechanical complications during dual active fixation. Pacing Clin Electrophysiol1996; 19: 1828–1831.
6.
RefaatMMHashashJGShalabyAA. Late perforation by cardiac implantable electronic device leads: clinical presentation, diagnostic clues, and management. Clin Cardiol2010; 33: 466–475.
7.
Dos SantosLFCostaFCorreiaE. Delayed lead perforation: a rare cause of pacemaker dysfunction. Rev Port Cardiol2011; 30: 599–609.
8.
StefanidisASMargosPNKotsakisAA. Three-dimensional echocardiographic documentation of pacemaker lead perforation presenting as acute pericarditis. Hellenic J Cardiol2009; 50: 335–337.
9.
OhJKSewardJBTajikAJ. The echo manual, 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2006.
10.
RydlewskaAMałeckaBZabekA. Delayed perforation of the right ventricle as a complication of permanent cardiac pacing - is following the guidelines always the right choice? Non-standard treatment - a case report and literature review. Kardiol Pol2010; 68: 357–361.
11.
WilkoffBLLoveCJByrdCL. Transvenous lead extraction: Heart Rhythm Society expert consensus on facilities, training, indications, and patient management: this document was endorsed by the American Heart Association (AHA). Heart Rhythm2009; 6: 1085–1104.
