Why the study?
Atrial lead perforation typically causes pneumopericardium or pneumothorax within days of device implantation, with very late-onset presentations remaining poorly characterized.
Highlights that very late-onset atrial lead perforation can cause pneumopericardium and may resolve with conservative management.
Conservative management may be feasible for pneumopericardium from late atrial lead perforation; this Level 5 case leaves open need for prospective data.
BACKGROUND: Atrial lead perforation may lead to pneumopericardium or pneumothorax within a few days of device implantation. METHODS AND RESULTS: We report a case of atrial lead perforation 6 years after cardiac resynchronization therapy implantation, which resulted in pneumopericardium and pneumothorax. CONCLUSION: Although pneumopericardium caused by atrial lead perforation can spontaneously resolve with conservative treatment, as it did in this case, treatment should be decided based on the patient's general condition and lead performance.
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Enokizono et al. (2023) studied this question.
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