Early right ventricular pacing lead perforation can be suspected on echocardiography, confirmed by CT, and successfully managed by percutaneous lead repositioning.
May allow early echo/CT diagnosis and percutaneous repositioning of RV lead perforation; leaves open need for prospective safety data.
We report a case of a 77-year-old patient with complete atrioventricular block. She underwent permanent pacemaker implantation complicated by right ventricular lead perforation. This was suspected on transthoracic echocardiogram and confirmed by chest computed tomography. The lead was repositioned in the cardiac electrophysiology lab followed by an uneventful course thereafter.
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Nash et al. (2014) studied this question.
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