Key result
Right ventricular lead perforation can occur through the thick ventricular septum and left ventricle, abutting the left anterior descending artery, even after placement in the septal position.
Why the study?
Cardiac perforation is an uncommon complication of transvenous pacemaker implantation that typically occurs through the apex.
Case Report (n=1)
This case illustrates that right ventricular lead perforation can occur even after placement in the septal position and through the thick ventricular wall.
May warrant close post-implant monitoring after septal RV lead placement; hypothesis-generating for perforation risks and prevention.
BACKGROUND: Cardiac perforation is an uncommon complication of transvenous pacemaker implantation typically occurring through the apex. CASE SUMMARY: We report a case of patient, in whom ventricular lead perforation was confirmed 6 days after implantation of a dual chamber pacemaker. The ventricular lead was perforating the ventricular septum, near the left anterior descending artery, exiting the left ventricle. The patient underwent cardiac surgery due to the lead perforation as also as aortic valve replacement due to concomitant severe aortic valve stenosis. DISCUSSION: The presented case report is a rare case of lead perforation through the LV and illustrates that lead perforation can still occur even after placement of the RV lead in septal position and even through the thick ventricular wall.
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Mililis et al. (2022) conducted a case report in Ventricular lead perforation (n=1). Right ventricular lead placement was evaluated on Ventricular lead perforation. Right ventricular lead perforation can occur through the thick ventricular septum and left ventricle, abutting the left anterior descending artery, even after placement in the septal position.
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