Key result
Percutaneous lead extraction using a laser sheath successfully treated an ultra-chronic ICD lead perforation with a 17-year dwell time, leading to symptom resolution.
Why the study?
Chronic ICD lead perforation is a rare but serious complication, often diagnosed via computed tomography.
Case Report (n=1)
This case demonstrates the feasibility of percutaneous lead extraction for an ultra-chronic (17-year dwell time) ICD lead perforation presenting as an FDG-avid pericardial effusion.
Should not yet change practice for chronic ICD lead perforation; leaves open feasibility of laser extraction after ultra-long dwell times.
Chronic implantable cardioverter-defibrillator (ICD) lead perforation is a rare but serious complication, often diagnosed via computed tomography. A 51-year-old man with cardiac sarcoidosis and a dual-chamber ICD presented with progressive chest pain. A routine 18F-fluoro-2-deoxy-2-D-glucose (FDG) positron emission tomography/computed tomography scan revealed an FDG–avid cystic lesion, later confirmed as an inflammatory pericardial effusion with gross ICD lead perforation. Echocardiography showed right ventricular compression. He had percutaneous lead extraction using a laser sheath, with symptom resolution. This case, with a 17-year dwell time, represents the longest documented chronic perforation successfully treated percutaneously, highlighting an unusual presentation in a patient with cardiac sarcoidosis.
No takes yet. Share an insight, caveat, or question.
Litt et al. (2025) conducted a case report in Chronic ICD lead perforation (n=1). Percutaneous lead extraction using a laser sheath was evaluated on Symptom resolution. Percutaneous lead extraction using a laser sheath successfully treated an ultra-chronic ICD lead perforation with a 17-year dwell time, leading to symptom resolution.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: