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Int J Angiol 2016; 25(05): e177-e179
DOI: 10.1055/s-0036-1580700
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cardiac Tamponade after Right Ventricular Perforation Caused by Screw-in Lead

Lovel Giunio
1   Department of Cardiology, University Hospital Centre Split, Split, Croatia
,
Teo Boric
2   Division of Vascular Surgery, Department of Surgery, University Hospital Centre Split, Split, Croatia
,
Cristijan Bulat
3   Department of Cardiac Surgery, University Hospital Centre Split, Split, Croatia
,
Dragan Dragicevic
4   Department of Radiology, University Hospital Centre Split, Split, Croatia
,
Mislav Lozo
1   Department of Cardiology, University Hospital Centre Split, Split, Croatia
› Author Affiliations
Further Information

Publication History

Publication Date:
04 April 2016 (online)

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Abstract

A 69-year-old man was admitted after syncope followed with chest pain and signs of cardiac tamponade. He had undergone permanent dual-chamber pacemaker implantation 3 weeks earlier. Transthoracic echocardiography (TTE) confirmed a pericardial effusion, and urgent pericardial drainage was performed. Right ventricular perforation caused by active-fixation (screw-in) lead was verified by multislice computed tomography. The lead was extracted under fluoroscopy and bedside TTE monitoring in the operating room with cardiothoracic surgery backup. In the same act, the new ventricular passive-fixation lead was implanted.

Keywords

cardiac tamponade - right ventricular perforation - pacemaker - screw-in lead - complications - pericardial drainage - multislice computed tomography
 

  • References

  • 1 Kiviniemi MS, Pirnes MA, Eränen HJ, Kettunen RV, Hartikainen JE. Complications related to permanent pacemaker therapy. Pacing ClinElectrophysiol 1999; 22 (5) 711-720
    PubMedGoogle Scholar
  • 2 Mahapatra S, Bybee KA, Bunch TJ , et al. Incidence and predictors of cardiac perforation after permanent pacemaker placement. Heart Rhythm 2005; 2 (9) 907-911
    CrossrefPubMedGoogle Scholar
  • 3 Sterliński M, Przybylski A, Maciag A , et al. Subacute cardiac perforations associated with active fixation leads. Europace 2009; 11 (2) 206-212
    PubMedGoogle Scholar
  • 4 Geyfman V, Storm RH, Lico SC, Oren IV JW. Cardiac tamponade as complication of active-fixation atrial lead perforations: proposed mechanism and management algorithm. Pacing ClinElectrophysiol 2007; 30 (4) 498-501
    PubMedGoogle Scholar
  • 5 Trigano AJ, Taramasco V, Paganelli F, Gerard R, Lévy S. Incidence of perforation and other mechanical complications during dual active fixation. Pacing ClinElectrophysiol 1996; 19 (11 Pt 2): 1828-1831
    PubMedGoogle Scholar
  • 6 Khan MN, Joseph G, Khaykin Y, Ziada KM, Wilkoff BL. Delayed lead perforation: a disturbing trend. Pacing ClinElectrophysiol 2005; 28 (3) 251-253
    PubMedGoogle Scholar
  • 7 Henrikson CA, Leng CT, Yuh DD, Brinker JA. Computed tomography to assess possible cardiac lead perforation. Pacing ClinElectrophysiol 2006; 29 (5) 509-511
    PubMedGoogle Scholar
  • 8 Amara W, Cymbalista M, Sergent J. Delayed right ventricular perforation with a pacemaker lead into subcutaneous tissues. Arch Cardiovasc Dis 2010; 103 (1) 53-54
    CrossrefPubMedGoogle Scholar
  • 9 Bigdeli AK, Beiras-Fernandez A, Kaczmarek I, Kowalski C, Schmoeckel M, Reichart B. Successful management of late right ventricular perforation after pacemaker implantation. Vasc Health Risk Manag 2010; 6: 27-30
    PubMedGoogle Scholar