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Related Experiment Videos

Delayed lead perforation: a disturbing trend.

Mohammed N Khan1, George Joseph, Yaariv Khaykin

  • 1Cleveland Clinic Foundation, Department of Cardiology, Cleveland, OH 44195, USA.

Pacing and Clinical Electrophysiology : PACE
|March 1, 2005
PubMed
Summary
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Delayed lead perforation, a rare cardiac device complication, can occur months after implantation. This study recommends a management approach for patients experiencing this issue.

Area of Science:

  • Cardiology
  • Medical Devices
  • Cardiac Electrophysiology

Background:

  • Delayed lead perforation is an uncommon but serious complication following cardiac electronic device implantation.
  • The underlying mechanisms and best treatment strategies for delayed lead perforation remain poorly understood.

Observation:

  • Three cases of delayed lead perforation were observed between 6 and 10 months post-implantation in patients with low-profile active fixation leads.
  • Patients presented with subacute symptoms including pleuritic chest pain, confirmed by chest X-ray and device interrogation.

Findings:

  • Extraction of the perforated lead was successfully performed under transesophageal echocardiography (TEE) guidance with cardiac surgery support.
  • All patients tolerated the lead extraction procedure without any immediate complications.

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Implications:

  • The findings support the development of a standardized management protocol for delayed lead perforation.
  • Prompt diagnosis and intervention, including lead extraction, are crucial for managing this rare complication.