What are the clinical features and management of late complications following pacemaker implantation with active-fixation leads?
Late perforation and pericarditis are uncommon but potentially fatal complications that can occur days to months after pacemaker implantation with active-fixation leads, requiring early recognition.
Acute complications resulting from permanent pacemaker implantation are well known and include perforation of the right atrium or right ventricle. Recently, several reports have described the occurrence of perforation and pericarditis as late complications following pacemaker implantation. These complications may occur days to weeks following uncomplicated pacemaker implantation and may lead to death if they are not recognized early. Five patients with late complications caused by active-fixation leads are reported and the clinical features of their presentation and management are reviewed. Late perforation of the right atrium or right ventricle is an uncommon complication after pacemaker implantation but should be suspected by the general cardiologist in a patient who has a device implanted within a week to several months prior to the development of chest pain.
Ellenbogen et al. (Thu,) studied this question.