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Updated: May 22, 2026

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
16:40

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

Cardiac chambers perforation by pacemaker and cardioverter-defibrillator leads. Own experience in diagnosis,

Andrzej Maziarz1, Andrzej Ząbek, Barbara Małecka

  • 1Department of Electrocardiology, The John Paul II Hospital, Krakow, Poland. buna@wp.pl

Kardiologia Polska
|May 25, 2012
PubMed

Insights

Cardiac perforation from pacemaker or cardioverter-defibrillator implantation is a rare but serious risk. Early diagnosis and appropriate lead removal techniques are crucial for patient outcomes.

Area of Science:

  • Cardiology
  • Medical Devices
  • Cardiac Surgery

Background:

  • Cardiac chamber perforation is a rare but serious complication following pacemaker (PM) or cardioverter-defibrillator (ICD) implantation.
  • Clinical presentation varies based on timing, perforation site, and associated injuries.

Observation:

  • Diagnosis involves clinical assessment, ECG, device interrogation, echocardiography, X-ray, and CT scans.
  • Seven cases of perforation were analyzed, with perforating leads removed in all instances.
  • New pacing systems were implanted in five patients.

Findings:

  • Operative techniques for lead removal included direct traction, Cook system, or surgical pericardial drainage.
  • The choice of technique depended on implantation-to-perforation time, extra-organ lesions, and pericardial effusion.
  • Preventive measures focus on avoiding specific lead placements (RV apex/free wall, RA free anterolateral wall), excessive lead tension, and over-screwing the helix.

Implications:

  • Proper lead placement and implantation technique are critical for preventing cardiac perforation.
  • Timely diagnosis and appropriate management strategies are essential for successful lead removal and patient recovery.
  • Understanding risk factors aids in developing safer implantation protocols for cardiac electronic devices.

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