Recurrent Pericardial Effusion Resulting From Right Ventricular Free Wall Injury Caused by Leadless Pacemaker Tines
Takafumi Oka1, Kentaro Ozu1, Takayuki Sekihara1
1Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
JACC. Case Reports
|June 3, 2024
Summary
A leadless pacemaker caused delayed cardiac tamponade and effusion due to ventricular wall penetration. Surgical intervention was required to address this serious complication.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Device Technology
Background:
- Leadless pacemakers offer a minimally invasive alternative for cardiac rhythm management.
- Complications, though rare, require careful consideration and prompt management.
Observation:
- An 87-year-old male presented with delayed cardiac tamponade 55 minutes post-leadless pacemaker implantation.
- Recurrent pericardial effusion was noted 20 days later.
Findings:
- Electrocardiogram-gated enhanced cardiac computed tomography identified leadless pacemaker tines penetrating the right ventricular free wall.
- The penetration was located on the lateral side of the device.
Implications:
- This case highlights a rare but severe complication of leadless pacemaker implantation.
- Prompt diagnosis and surgical intervention (off-pump hemostatic surgery) are crucial for managing ventricular perforation by cardiac devices.
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