Delayed right ventricular lead perforation by a pacemaker lead 2-year post-implantation

Area of Science:

• Cardiology
• Medical Devices
• Cardiac Electrophysiology

Background:

• Cardiac implantable electronic devices (CIEDs) are crucial for managing cardiac arrhythmias.
• Lead perforation is a known, albeit uncommon, complication associated with CIEDs.
• Perforation typically manifests early, within 24 hours of implantation.

Observation:

• This report details a unique case of cardiac perforation.
• The complication involved the lead of a pacemaker.
• The perforation occurred in the right ventricular wall.

Findings:

• The patient experienced cardiac perforation two years after initial pacemaker implantation.
• This represents a delayed or chronic presentation of lead perforation.
• The right ventricular wall was identified as the site of perforation.

Implications:

• Delayed cardiac perforation by CIED leads is possible, extending beyond the acute post-operative period.
• This case underscores the importance of considering late complications in patients with pacemakers.
• Awareness of chronic lead perforation is vital for accurate diagnosis and patient management.