Pacemaker leads and cardiac perforation
Andrew Peter Vanezis1, Rachana Prasad1, Richard Andrews1
1The Lincolnshire Heart Centre, Lincoln County Hospital, Lincoln LN2 5QY, UK.
JRSM Open
|March 22, 2017
Insights
Pacemaker leads can rarely cause life-threatening ventricular perforation. This case series reviews diagnostic methods and treatment options for this serious cardiac complication.
Area of Science:
- Cardiology
- Medical Devices
- Cardiac Electrophysiology
Background:
- Pacemaker implantation is a common procedure for managing cardiac arrhythmias.
- Ventricular perforation by pacemaker leads is a rare but critical complication.
Observation:
- This case series details instances of ventricular perforation secondary to pacemaker lead placement.
- Clinical presentations varied, underscoring the need for high clinical suspicion.
Findings:
- Diagnostic imaging, including echocardiography and computed tomography, is crucial for identifying perforation.
- Management involves prompt recognition and often surgical intervention to address the perforation and reposition or remove the lead.
Implications:
- Early diagnosis and appropriate management are vital to improve patient outcomes and reduce mortality associated with pacemaker lead perforation.
- This highlights the importance of ongoing vigilance and refinement of implantation techniques to minimize risks.
Abstract:
This case series highlights the rare but potentially life threatening complication of ventricular perforation caused by pacemaker leads and discusses appropriate investigations and management strategies.
Related Concept Videos
01:22Esophageal Perforation-I: Introduction
687
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....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
687
01:28Esophageal Perforation-II: Clinical Manifestations and Management
862
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:
Clinical Manifestations:
862
01:19Conduction System of the Heart
14.2K
Autorhythmicity is a term that refers to the heart's inherent ability to generate electrical signals and instigate muscle contractions. This self-regulating conduction system within the heart consists of two key components: the pacemaker cells and specialized conducting cells.
The pacemaker cells are located in two primary nodes: the sinoatrial (SA) node and the atrioventricular (AV) node. The SA node pacemaker cells can autonomously depolarize, triggering an action potential that leads to the...
The pacemaker cells are located in two primary nodes: the sinoatrial (SA) node and the atrioventricular (AV) node. The SA node pacemaker cells can autonomously depolarize, triggering an action potential that leads to the...
14.2K
01:20Conduction System of the Heart
4.7K
The cardiac conduction system produces and transmits electrical impulses that prompt myocardial contraction, ensuring efficient heart function. This intricate system ensures that the heart beats in a coordinated and efficient manner, beginning with the atria and then the ventricles. The conduction system optimizes cardiac output by maintaining this precise sequence, which is crucial for adequate blood circulation.
This system relies on the unique properties of nodal and Purkinje cells:...
This system relies on the unique properties of nodal and Purkinje cells:...
4.7K
01:25Pericarditis IV: Nursing Management
483
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.
483
01:19Electrophysiology of Normal Cardiac Rhythm
10.0K
The normal cardiac rhythm is a synchronized electrical activity that facilitates the regular and coordinated contraction of the heart muscle. This process is essential for efficient blood circulation throughout the body. The fundamental elements involved in establishing and maintaining this rhythm include the unique electrical properties of cardiac muscle cells, the sinoatrial (SA) node's pacemaker function, the specialized conducting system, and the ionic mechanisms underlying each phase...
10.0K