Late atrial appendage perforation from a pacemaker lead pacemaker complication

Area of Science:

• Cardiology
• Medical Devices
• Cardiac Electrophysiology

Background:

• Lead perforation is a known but infrequent complication of cardiac electronic device implantation.
• The incidence of lead perforation typically ranges from 0.3% to 1%.

Observation:

• Late lead perforations, occurring more than one month post-implantation, are considered exceptionally rare.
• A 65-year-old male patient presented with late cardiac perforation.

Findings:

• The perforation was attributed to an active fixation pacemaker lead.
• The patient's initial pacemaker implantation procedure was uneventful.
• Successful treatment of the late cardiac perforation was achieved.

Implications:

• This case highlights the importance of considering late lead perforation even after uncomplicated pacemaker implantation.
• It underscores the need for vigilance and appropriate management strategies for rare device complications.
• Further research may be warranted to understand the mechanisms and risk factors for late lead perforations.