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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Delayed cardiac perforation by one small body diameter defibrillator lead
Majid Haghjoo1, Abolfath Alizadeh, Amir Farjam Fazelifar
1Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Mellat Park, Tehran, Iran. majid.haghjoo@gmail.com
Journal of Electrocardiology
|June 13, 2009
Summary
A patient experienced chest pain after implantable cardioverter-defibrillator (ICD) placement due to lead perforation. Successful lead repositioning resolved the issue, highlighting a rare complication of ICD therapy.
Area of Science:
- Cardiology
- Medical Devices
- Electrophysiology
Background:
- Implantable cardioverter-defibrillators (ICDs) are crucial for managing life-threatening arrhythmias.
- Lead integrity and proper placement are essential for effective ICD function.
- Delayed complications after device implantation require careful consideration.
Observation:
- A 37-year-old male presented with persistent chest pain six weeks post-ICD implantation.
- Device interrogation revealed a complete loss of capture, even at maximum output.
- Imaging studies confirmed the ICD lead tip was outside the cardiac structure.
Findings:
- The patient's symptoms were attributed to delayed cardiac perforation by the St Jude Medical Durata ICD lead.
- Lead repositioning in the electrophysiology lab successfully restored pacing capture.
- The procedure was performed without any immediate complications.
Implications:
- This case underscores the potential for delayed lead perforation as a rare complication of ICD implantation.
- Prompt diagnosis and intervention, such as lead repositioning, are critical for managing such events.
- Awareness of this complication is important for clinicians managing patients with ICDs.
