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Pneumopericardium and pneumothorax contralateral to venous access site after permanent pacemaker implantation
K Srivathsan1, R A Byrne, C P Appleton
1Division of Cardiovascular Diseases, Mayo Clinic Scottsdale, Phoenix, AZ 85054, USA.
Abstract:
A 77-year-old female underwent implantation of a left-sided dual chamber permanent pacemaker for symptomatic bradycardia with active fixation leads. Eight hours after the procedure, the patient complained of shortness of breath and was found to have a 30% right pneumothorax on chest X-ray. Immediately, a chest tube was inserted, promptly relieving the symptoms. A CT scan of the chest revealed extrusion of the helix of the screw-in atrial lead, through the wall of the right atrial appendage. The helix was abutting a bulla in the right lung, the likely cause for pneumothorax and pneumopericardium. The atrial lead was explanted without incident.
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