Related Experiment Video

Updated: May 23, 2026

Translational Rabbit Model of Chronic Cardiac Pacing
06:14

Translational Rabbit Model of Chronic Cardiac Pacing

Published on: January 6, 2023

Heart perforation in patients with permanent cardiac pacing - pilot personal observations

Justyna Piekarz1, Jacek Lelakowski, Anna Rydlewska

  • 1Jagiellonian University, Collegium Medicum, Institute of Cardiology, Department of Electrocardiology, John Paul II Hospital, Krakow, Poland.

Archives of Medical Science : AMS
|March 30, 2012
PubMed

Insights

Heart perforation from pacemaker or implantable cardioverter-defibrillator leads is rare but serious. Prompt diagnosis via CT and appropriate lead removal, often by traction or surgery, are crucial for patient outcomes.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Medical Device Complications

Background:

  • Heart perforation is a rare but significant complication following pacemaker (PM) and implantable cardioverter-defibrillator (ICD) implantation.
  • This study investigates a cohort of patients who experienced heart perforation after PM/ICD implantation.

Purpose of the Study:

  • To analyze the incidence, clinical presentation, diagnostic methods, and management strategies for heart perforation after PM/ICD implantation.
  • To evaluate the effectiveness of different lead removal techniques.

Main Methods:

  • Retrospective analysis of 6 patients hospitalized for heart perforation between 2005-2010.
  • Review of medical records, imaging (X-ray, echocardiography, CT), and procedural data.
  • Assessment of lead extraction methods including direct traction, percutaneous extraction, and surgical intervention.

Main Results:

  • The incidence of heart perforation was 0.09%.
  • Symptoms appeared between 4 to 990 days post-implantation.
  • Computed tomography (CT) confirmed perforation in all cases, with lead perforation sites in the right atrium (1) and right ventricle (6). Echocardiography revealed pericardial effusion (>10mm).
  • Lead removal involved direct traction or percutaneous extraction with pericardiocentesis in 5 cases, and cardiac surgery in 1 case.

Conclusions:

  • Direct lead traction in the operating room, with multidisciplinary support, is a viable removal method for uncomplicated perforations.
  • Cardiac surgery is recommended for perforations outside the pericardial sac or with atypical locations.
  • Computed tomography is the most critical diagnostic tool for identifying heart perforation.
Abstract

Keywords:
heart perforationpacemaker/cardioverter-defibrillator implantation

More Related Videos

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation08:56

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation

Published on: September 24, 2021

Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine10:05

Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine

Published on: July 7, 2016

Related Concept Videos

Cardiac Catheterization II: Right Heart Catheterization01:21

Cardiac Catheterization II: Right Heart Catheterization

Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Pulse rhythm01:30

Pulse rhythm

Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations: