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Right Ventricle Perforation Post Pacemaker Insertion Complicated with Cardiac Tamponade.
Muhammad Khalid1, Ghulam Murtaza1, Muhammad Talha Ayub2
1Department of Internal Medicine, East Tennessee State University.
Cureus
|May 9, 2018
Summary
Pacemaker lead perforation of the right ventricle is a serious complication that can be fatal. Diagnosis involves imaging, and management depends on the patient's condition, with extraction avoided in chronic cases.
Area of Science:
- Cardiology
- Medical Devices
- Cardiac Surgery
Background:
- Pacemaker lead perforation of the right ventricle is a rare but severe complication.
- Acute perforation typically manifests within 24 hours of implantation.
- Fatal outcomes such as hemopericardium, cardiac tamponade, and death can occur.
Observation:
- Patients with lead perforation may be asymptomatic.
- Diagnostic tools include chest X-ray, computed tomography (CT) scans, and echocardiography.
- Clinical presentation dictates the management strategy.
Findings:
- Extraction of pacemaker leads is generally avoided in chronic, asymptomatic perforations due to associated risks.
- Urgent intervention is crucial for hemodynamically unstable patients presenting with pericardial effusion or cardiac tamponade.
- Timely diagnosis and appropriate management are critical for patient outcomes.
Implications:
- This highlights the importance of vigilant monitoring for pacemaker lead complications.
- Understanding diagnostic modalities and management options is essential for clinicians.
- Further research into safer lead designs and extraction techniques may be warranted.
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