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Delayed complications following pacemaker implantation.

Kenneth A Ellenbogen1, Mark A Wood, Richard K Shepard

  • 1Department of Medicine (Cardiology), Medical College of Virginia/Virginia Commonwealth University, Richmond 23298-00053, USA. Kellenbogen@pol.net

Pacing and Clinical Electrophysiology : PACE
|October 3, 2002
PubMed
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Late pacemaker lead perforation is a rare but serious complication, potentially occurring weeks after implantation. Early recognition of chest pain in patients with implanted devices is crucial for timely intervention and preventing fatalities.

Area of Science:

  • Cardiology
  • Medical Devices
  • Cardiac Surgery

Background:

  • Permanent pacemaker implantation is a common procedure for managing bradyarrhythmias.
  • While acute complications are recognized, late complications can also arise.
  • Perforation and pericarditis are significant late complications following pacemaker implantation.

Observation:

  • This report details five cases of late cardiac perforation caused by active-fixation pacemaker leads.
  • These events occurred days to weeks after initial pacemaker implantation.
  • Patients presented with symptoms such as chest pain, necessitating prompt medical evaluation.

Findings:

  • Late perforation of the right atrium or ventricle, though uncommon, is a critical complication.
  • Active-fixation leads were implicated in the reported cases of delayed perforation.

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  • The time frame for these late complications ranged from a week to several months post-implantation.

    • Implications:

    • Cardiologists must maintain a high index of suspicion for late perforation in patients presenting with chest pain after pacemaker implantation.
    • Prompt diagnosis and management are vital to prevent potentially fatal outcomes.
    • This highlights the importance of long-term device monitoring and patient follow-up.