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Updated: Jan 4, 2026
A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Delayed presentation of right ventricular lead perforation following defibrillator implantation: a case report
Daniel Ahlert1, Andrew R J Mitchell1
1Department of Cardiology, Jersey General Hospital, Gloucester Street, St Helier JE1 3QS, Jersey.
Insights
Myocardial perforation is a rare but serious complication of cardiac device implantation. Early diagnosis with echocardiography is crucial for prompt management and improved patient outcomes.
Area of Science:
- Cardiology
- Medical Devices
- Cardiac Surgery
Background:
- Myocardial perforation is a known complication of cardiac device implantation.
- It carries significant morbidity and mortality.
- Awareness of diagnosis and management is vital for clinicians.
Observation:
- A 48-year-old woman presented with chest and shoulder pain one month post-implantable cardioverter-defibrillator implantation.
- Initial assessment showed bilateral pleural effusions and anemia.
- Computed tomography revealed a pericardial effusion.
Findings:
- Transthoracic echocardiography confirmed right ventricular perforation.
- The patient underwent urgent system revision.
Implications:
- This case underscores the importance of clinical suspicion for myocardial perforation.
- Diagnostic echocardiography is a key tool for symptomatic patients post-cardiac device implantation.
Background:
Perforation of a device lead through the myocardium is a recognized complication of cardiac device implantation. The associated morbidity and mortality are significant, even though it is a relatively rare complication. Therefore, it is vital for acute clinicians to be aware of the diagnosis and subsequent management of myocardial perforation.
Case Summary:
We present the case of a 48-year-old woman who presented to the emergency department 1 month following implantable cardioverter-defibrillator implantation with chest and shoulder pain. Initial assessment revealed bilateral pleural effusions and anaemia. Computerized tomography of her chest and abdomen demonstrated a pericardial effusion, but it was transthoracic echocardiography that confirmed the diagnosis of right ventricular perforation. Urgent system revision was undertaken.
Discussion:
This case highlights the importance of clinical suspicion and the use of diagnostic echocardiography as an important diagnostic tool in symptomatic patient's post-cardiac device implantation.
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