Related Experiment Video
Updated: Sep 28, 2025
06:14
Translational Rabbit Model of Chronic Cardiac Pacing
Published on: January 6, 2023
2.8K
Fatigue and Syncope Caused by Right Ventricular Perforation by a Pacemaker Lead
Jehanzeb A Khan1, Shuja Abdul Karim Khan2
1Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
Cureus
|April 4, 2022
Summary
Cardiac device leads can perforate heart ventricles, posing a diagnostic challenge. This case highlights successful lead replacement via fluoroscopy, enabling early patient discharge and reducing healthcare burdens.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Cardiology
Background:
- Intraventricular leads in cardiac devices carry a risk of cardiac perforation.
- Clinical presentation of lead perforation ranges from asymptomatic findings to cardiac tamponade.
- Accurate diagnosis and timely intervention are crucial for patient outcomes.
Observation:
- A patient with a permanent pacemaker for complete heart block presented with fatigue and syncope.
- Electrocardiogram showed bradycardia with junctional escape rhythm.
- Imaging revealed the right ventricular lead tip had perforated the ventricular wall.
Findings:
- The perforated cardiac lead was successfully repositioned and replaced under fluoroscopic guidance.
- No surgical intervention was required for lead management.
- The patient was discharged on the first post-procedure day.
Implications:
- Fluoroscopic guidance offers a safe and effective method for managing cardiac lead perforation.
- Minimally invasive lead replacement facilitates early patient discharge.
- Early discharge reduces healthcare facility burden and patient hospitalization duration.
Keywords:
economic burden of healthcarepacemaker extractionpacemaker lead displacementpacemaker lead perforationpermanent pacemakerpermanent pacemaker (ppm) complicationright ventricular perforationMore Related Videos
Related Concept Videos
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
137
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
137
01:20Mitral Regurgitation I: Introduction
74
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
74
01:26Imbalances in Cardiac Output
1.6K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.6K
01:21Cardiac Catheterization II: Right Heart Catheterization
210
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
210
01:30Cardiomyopathy II: Dilated Cardiomyopathy
44
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
44
01:22Esophageal Perforation-I: Introduction
195
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
195