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Related Experiment Video

Updated: Aug 12, 2025

Translational Rabbit Model of Chronic Cardiac Pacing

Translational Rabbit Model of Chronic Cardiac Pacing

Published on: January 6, 2023

Case report: Left ventricular perforation caused by right ventricular pacemaker lead.

Xiang Huang¹, Heng Zhou¹, Xiao-Mei Li¹

¹Department of Cardiology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China.

Frontiers in Cardiovascular Medicine

|January 30, 2023

Summary

A rare pacemaker complication occurred when a right ventricular (RV) lead perforated the left ventricular (LV) wall. Prompt lead extraction and repositioning successfully resolved the issue in this case report.

Keywords:

lead migration left ventricular perforation pacemaker right ventricular pacemaker lead transvenous lead extraction

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Area of Science:

Cardiology
Medical Devices
Cardiac Electrophysiology

Background:

Right ventricular (RV) lead perforation of the interventricular septum and left ventricular (LV) free wall is a rare but severe complication of pacemaker (PM) implantation.
This case report details the diagnosis and management of an unusual LV perforation caused by an RV pacing lead.

Observation:

A 92-year-old male with complete atrioventricular block underwent dual-chamber PM implantation.
Postoperative pacemaker failure on the second day led to a CT scan revealing RV lead perforation of the interventricular septum and LV free wall.

Findings:

Transvenous lead extraction of the penetrating RV lead was performed without complications.
The RV lead was successfully repositioned at the lower RV septum on the fifth postoperative day.

Implications:

Identifying high-risk patients is crucial for preventing this life-threatening complication.
Transvenous lead extraction, potentially with cardiac surgery backup, is a viable management option.