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Chronic ventricular lead perforation: Expect the unexpected
Baldeep S Sidhu1,2, Ronak Rajani1,2, Christopher A Rinaldi1,2
1Cardiology Department Guy's & St Thomas' Hospitals London UK.
Insights
Diagnosing chronic right ventricular lead perforation requires a high index of suspicion, especially with new breathlessness and pacing changes. Contrast-enhanced CT is highly accurate for diagnosis, with percutaneous extraction being common.
Area of Science:
- Cardiology
- Medical Imaging
- Electrophysiology
Background:
- Chronic lead perforation is a rare but serious complication of cardiac implantable electronic devices.
- Symptoms may be nonspecific, leading to delayed diagnosis.
Abstract:
A high index of suspicion is needed to diagnose a chronic right ventricular lead perforation. They should be suspected in patients who develop breathlessness and have a sudden change in pacing parameters. Contrast-enhanced CT provides high diagnostic accuracy. They can often be extracted percutaneously and rarely require surgical intervention.
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