Key result
Implantation of two active screw-in leads for a permanent pacemaker resulted in perforation of the atrial and ventricular walls, causing cardiac tamponade and a left hemothorax.
Case Report (n=1)
Active screw-in pacemaker leads can rarely cause life-threatening complications such as cardiac tamponade and hemothorax that may require emergency open-heart surgery.
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Alerts clinicians to rare perforation risk with active screw-in leads; leaves open optimal lead selection and prevention strategies.
We describe the case of a 77-year-old female who underwent dual-chamber permanent pacemaker implantation using two active screw-in leads for complete atrioventricular block. The two active screw-in leads perforated the atrial and ventricular walls causing cardiac tamponade and a left hemothorax associated with ventricular perforation. An emergency sternotomy was performed to facilitate drainage and hemostasis. Although hemothorax due to pacing lead perforation is very rare, such a possibility should always be considered.
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Morita et al. (2013) conducted a case report in Complete atrioventricular block (n=1). Dual-chamber permanent pacemaker implantation using two active screw-in leads was evaluated on Cardiac perforation and hemothorax. Implantation of two active screw-in leads for a permanent pacemaker resulted in perforation of the atrial and ventricular walls, causing cardiac tamponade and a left hemothorax.
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