Inadvertent left ventricular pacing and perforation by a temporary pacemaker.

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Device Complications

Background:

• Myocardial perforation by pacemaker electrodes is a rare but severe complication.
• While typically involving the right ventricle, left ventricular perforation is less common.

Observation:

• An 82-year-old female patient experienced left ventricular pacing post-temporary pacemaker implantation.
• Diagnostic evaluation confirmed myocardial perforation.
• Emergency thoracotomy revealed perforation near the left ventricular apex.

Findings:

• The case highlights a rare instance of left ventricular free wall perforation by a pacemaker electrode.
• Slow progression of perforation is possible in left ventricular cases.

Implications:

• Clinicians must maintain a high index of suspicion for left ventricular perforation.
• Prompt surgical intervention is crucial for managing this critical complication.