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Late left ventricular perforation by active fixation pacemaker lead implanted in the right ventricular septum
Haruhiko Kondoh1, Toshihiro Funatsu, Kazuhiro Taniguchi
1Department of Cardiovascular Surgery, Japan Labor Health and Welfare Organization, Osaka Rosai Hospital, Nagasone-cho, Sakai, Osaka, Japan. haruhk@wa3.so-net.ne.jp
Journal of Cardiac Surgery
|May 24, 2012
Summary
A pacemaker lead migrated three months after implantation, causing a rare late perforation of the left ventricle. Computed tomography confirmed the lead tip pierced the ventricular wall into the chest.
Area of Science:
- Cardiology
- Medical Devices
- Cardiac Surgery
Background:
- Pacemaker implantation is a common procedure for cardiac rhythm management.
- Lead migration is a known complication, though typically occurs earlier and presents with different symptoms.
- Late complications require careful consideration in patient follow-up.
Observation:
- A rare case of late left ventricular perforation is presented.
- The perforation was caused by a pacemaker lead implanted in the right ventricular septum three months prior.
- Preoperative computed tomography revealed the lead tip had migrated and perforated the ventricular wall.
Findings:
- The migrated pacemaker lead perforated the left ventricular wall.
- The perforation extended into the anterior chest wall near the intraventricular groove.
- This represents a rare late complication of pacemaker lead placement.
Implications:
- This case highlights the importance of recognizing late complications of pacemaker implantation.
- Advanced imaging like computed tomography is crucial for diagnosing lead perforation.
- Management strategies for such rare events need to be considered in clinical practice.
