Key result
A 71-year-old male experienced a rare, very late perforation of an ICD lead 11 months after implantation, resulting in a gradual haemorrhagic pericardial effusion requiring emergency pericardiocentesis.
Case Report (n=1)
Late lead perforation is a rare but potentially life-threatening complication of ICD implantation that should be considered in patients presenting with sudden chest pain or altered lead parameters.
Very late ICD lead perforation warrants consideration in unexplained effusions; case reports leave incidence and prevention strategies open.
Every year approximately 40 000 pacemakers and defibrillators are implanted in the UK amounting to one new implanted device per GP.1 Placements of pacemakers or implantable cardioverter defibrillators (ICDs) have become routine procedures and are generally associated with low complication rates. One of the most endangering complications is the perforation of electrodes. Usually the perforation of leads occurs shortly after implantation and it is an acute and potentially life-threatening event.2,3 Late lead perforations more than 1 month after initial implantation have been described as exceedingly rare incidents.4,5 A 71-year-old male with coronary artery disease, impaired left ventricular ejection fraction of 24%, and persistent atrial fibrillation was supplied with an ICD for primary prevention of sudden cardiac death. The patient was doing fine for 11 months while leading an active life both cycling and playing golf. He then experienced a sudden onset of thoracic pain related to deep in- …
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Semmler et al. (2014) conducted a case report in Implantable cardioverter defibrillator lead perforation (n=1). Implantable cardioverter defibrillator (ICD) lead was evaluated on Late lead perforation causing haemorrhagic pericardial effusion. A 71-year-old male experienced a rare, very late perforation of an ICD lead 11 months after implantation, resulting in a gradual haemorrhagic pericardial effusion requiring emergency pericardiocentesis.
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