Why the study?
Temporary transvenous pacemakers are lifesaving in hemodynamically unstable bradycardia but can lead to serious complications such as right ventricular perforation.
Preprocedural right ventriculography is useful for detecting asymptomatic temporary pacemaker lead perforations prior to leadless pacemaker implantation, enabling safe extraction with pericardiocentesis standby.
May alert to silent perforations with temporary leads; leaves open routine ventriculography before leadless pacemaker implantation.
Temporary transvenous pacemakers (TTPs) are lifesaving device in patients with hemodynamically unstable bradycardia, but are associated with serious complications, including right ventricular (RV) perforation. We present a case of a 91-year-old woman with complete atrioventricular block and bradycardia who received a TTP. After that, she underwent leadless pacemaker implantation. Preprocedural right ventriculography (RVG) revealed an incidental RV wall perforation by the TTP lead. After preparing for pericardiocentesis, the lead was safely extracted without complications. This case highlights the utility of RVG in detecting lead-related complications, where it is necessary to prepare pericardiocentesis prior to lead removal.
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Omote et al. (2025) studied this question.
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