Key result
Right ventricular lead perforation presenting as cardiac tamponade was successfully managed by open surgical extraction in a very late case and by simple traction in a subacute case.
Why the study?
Ventricular lead perforation is a rare, life-threatening complication of permanent pacemakers with an uncertain approach to treatment.
Case Report (n=2)
No
Right ventricular lead perforation can present as cardiac tamponade both subacutely and very late after implantation, and can be successfully managed via simple traction or open surgery depending on chronicity.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for timing-based management of RV lead perforation tamponade; prospective data needed before guiding practice.
Ventricular lead perforation (VLP) is a rare and life-threatening complication of permanent pacemakers. Generally, VLP emerges in acute and subacute periods after cardiac electronic devices are implanted. Late VLP is unexpected and occurs less frequently. There is an uncertain approach to the treatment of VLPs. Collaboration with cardiovascular surgeons is recommended. Herein, we present two cases of cardiac perforations who were successfully managed. One of them was admitted with cardiac tamponade four years after dual-chamber pacemaker (DCP) implantation, and the right ventricular lead was successfully removed with an open surgical method. The other was admitted with cardiac tamponade two weeks after DCP implantation. Ventricular lead was extracted by a simple traction method without surgical support and successfully re-implanted in the correct location.
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Göçer et al. (2021) conducted a case report in Right Ventricular Lead Perforation (n=2). Lead extraction (surgical or simple traction) was evaluated on Successful lead extraction and patient recovery. Right ventricular lead perforation presenting as cardiac tamponade was successfully managed by open surgical extraction in a very late case and by simple traction in a subacute case.
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