Inadvertent puncture of the right atrial free wall during transseptal catheterization can lead to shock, traumatic pericarditis, and atrial injury currents on ECG.
Three cases which developed shock and traumatic pericarditis following the inadvertent puncture of the free wall of the right atrium by the transseptal needle are described. All cases showed atrial injury current which was produced presumably by the puncture of the right atrial free wall in one case and by subepicardial atrial lesions following pericarditis in the other 2 cases.
UEDA et al. (Tue,) studied this question.