Key result
An 84-year-old female presented with recurrent syncope and was diagnosed with delayed pacemaker lead perforation 4.8 years after implantation, highlighting the lifelong risk of CRMD complications.
Case Report (n=1)
Highlights the lifelong risk of delayed lead perforation complications with cardiac rhythm management devices, which can present atypically even years after implantation.
Delayed perforation can cause late syncope after pacemaker implantation; case report leaves open optimal long-term CRMD surveillance.
Lead perforation is a major complication of cardiac rhythm management devices (CRMD), occurring in about 1%. While most lead perforations occur early, numerous instances of delayed lead perforation (occurring >30 days after implantation) have been reported in the last few years. Only about 40 such cases have been published, with the majority occurring <1 year after implantation. Herein, we describe the case of an 84-year-old female who presented with recurrent syncope and was diagnosed to have delayed pacemaker lead perforation 4.8 years after implantation. Through this report, we intend to highlight the increasing use of CRMD in elderly patients, and the lifelong risk of complications with these devices. Presentation can be atypical and a high index of suspicion is necessary for diagnosis.
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Alla et al. (2010) conducted a case report in Delayed pacemaker lead perforation (n=1). Cardiac rhythm management device (pacemaker) was evaluated on Delayed pacemaker lead perforation. An 84-year-old female presented with recurrent syncope and was diagnosed with delayed pacemaker lead perforation 4.8 years after implantation, highlighting the lifelong risk of CRMD complications.
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