Related Experiment Video
Updated: Aug 29, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Pericardial effusion and right-sided pneumothorax resulting from an atrial active-fixation lead
D Dilling-Boer1, H Ector, R Willems
1Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium.
Abstract:
We report on a patient in whom an active-fixation pre-shaped atrial lead caused perforation of the right atrial wall, pericardium and pleura, resulting in pericardial effusion and right-sided pneumothorax. Chest X-ray did not demonstrate protrusion of the atrial lead outside the cardiac silhouette but computed tomography visualized the tip of the helix of the atrial screw-in electrode outside the contours of the right atrial appendage touching the right upper lobe of the lung. The lead was repositioned with resolution of pericardial effusion and pneumothorax. Due to their proximity to the right lung, high anterolaterally positioned atrial screw-in leads carry a small but definite risk for right-sided pneumothorax.
Related Concept Videos
Pericarditis II: Clinical Features and Diagnostic Tests
Pneumothorax-II
Clinical Manifestations:
Pneumothorax II: Pathophysiology
Cardiac Catheterization II: Right Heart Catheterization
Pericarditis III: Medical Management
Pneumothorax-I
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.

