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Erosion of a right ventricular pacer lead into the left chest wall

Michael J Herr1,2, J Macy Cottrell3, H Edward Garrett4

  • 1College of Medicine, University of Tennessee Health Science Center, 910 Madison Ave. 10th floor, Memphis, TN, 38103, USA. mherr@uthsc.edu.

Surgical Case Reports
|October 7, 2020
PubMed

Insights

Pacer lead erosion into the chest wall can cause serious complications. This case highlights the successful removal of a migrated right ventricular pacing lead that penetrated a rib, with good patient recovery.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Device Complications

Background:

  • Pacer lead erosion into the chest wall can lead to severe outcomes like cardiac tamponade or arrest.
  • Complications include pericardial effusion, hypotension, and mediastinal rupture.

Purpose of the Study:

  • To report a unique case of pacer lead erosion.
  • To illustrate the management and successful outcome of a migrated pacing lead.
  • To support the removal of non-functional pacing leads.

Main Methods:

  • A case of a right ventricular pacer lead eroding into the chest wall and penetrating a rib is presented.
  • The patient presented with a chest wall mass but no effusion.
  • Surgical removal of the penetrated rib segment was performed.

Main Results:

  • The patient recovered well from the surgical procedure.
  • Discharge occurred one week post-operation.
  • No immediate complications were noted.

Conclusions:

  • Removal of temporary and non-functional pacing leads is justified.
  • This case expands the understanding of pacer lead migration complications.
  • Prompt intervention can lead to favorable patient outcomes.
Abstract

Keywords:
Chest wallPacing leadRib perforation

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