ArticleThe Journal of innovations in cardiac rhythm management2022
Diaphragmatic Pacing as an Initial Presentation of Delayed Ventricular Lead Perforation.
Article in The Journal of innovations in cardiac rhythm management, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 2 citations in OpenAlex.
- Late Fracture of Stylet-driven Lead Intended for Conduction System Pacing 2 Years After Implant.The Journal of innovations in cardiac rhythm management · 2026Article
- Delayed right ventricular perforation 3 years after permanent pacemaker implantation: a case report.International journal of surgery case reports · 2026Article
- Bow-and-arrow sign on point-of-care ultrasound for diagnosis of pacemaker lead-induced heart perforation: A case report and literature review.World journal of clinical cases · 2023Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Ventricular lead perforation is an infrequent and potentially fatal complication of pacemakers and implantable cardioverter-defibrillators that typically presents shortly following device implantation. Delayed lead perforations occurring 1 month after implantation are not widely reported and can have a wide range of presentations ranging from asymptomatic to potentially fatal cardiac tamponade. We describe a case of successful percutaneous lead extraction and revision in a patient who presented 9 months following implantation with an active fixation right ventricular pacing lead with apical perforation. Perforation was suspected when device interrogation showed ventricular sensing without ventricular capture, but with diaphragm stimulation. After an initial X-ray and transthoracic echocardiogram failed to detect it, computed tomography angiography confirmed the myocardial perforation. This case demonstrates the importance of recognizing such a complication following cardiac implantable electronic device implantation regardless of the timeline of presentation. It also serves to highlight the importance of clinical suspicion and awareness of the limitations of imaging for perforation. Transvenous percutaneous lead extraction and revision remains a favored approach due to reduced patient trauma when compared to the open surgical approach.
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