Highlights a rare presentation of delayed right atrial ICD lead perforation causing cardiac tamponade in a pediatric patient, managed via surgical repair without lead extraction.
Caution against generalizing single-case surgical repair without extraction in pediatric ICD perforation; leaves open optimal management strategies.
Myocardial lead perforation following cardiac implantable electronic device (CIED) implantation is rare. Lead perforations are classified as acute, subacute, or chronic based on the timing of presentation after the device implantation. The majority occur within the first 24 hours after device implantation. We report a case of a pediatric patient with implantable cardioverter-defibrillator (ICD) lead perforation leading to cardiac tamponade who subsequently underwent surgical repair of the perforation without lead extraction.
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Banala et al. (2024) studied this question.
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