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CA LÂM SÀNG Issue: Số 117 BỆNH RỐI LOẠN NHỊP TIM

Recognition and Management of Right Ventricular Wall Perforation Following Permanent Pacemaker Implantation: A Case Report

Nguyễn Mạnh Hùng: Trung tâm Tim mạch - Bệnh viện E;
Published: September 30, 2025
Views: 85
DOI 10.58354/jvc.117.2025.885

Abstract

Cardiac perforation is a rare but serious complication of a permanent pacemaker. Chest X-rays, cardiac computed tomography (CT) scans, or transthoracic echocardiography (TTE) are used to identify pacemaker lead perforation. However, the timing of cardiac perforation has been unclear. We report a case of early right ventricular perforation, diagnosed and determined the timing using the programmer. The patient was managed with the perforating electrode removed and a new electrode implanted safely in the Hybrid room with the surgical team on standby

References

1.
Khan MN, Joseph G, Khaykin Y, Ziada KM, Wilkoff BL. Delayed lead perforation: a disturbing trend. Pacing Clin Electrophysiol PACE. 2005;28(3):251-253. doi:10.1111/j.1540-8159.2005.40003.x
DOI: doi.org/10.1111/j.1540-8159.2005.40003.x
2.
Piekarz J, Lelakowski J, Rydlewska A, Majewski J. Heart perforation in patients with permanent cardiac pacing – pilot personal observations. Arch Med Sci AMS. 2012;8(1):70-74. doi:10.5114/aoms.2012.27284
DOI: doi.org/10.1111/j.1540-8159.2005.40003.x
3.
Hirschl DA, Jain VR, Spindola-Franco H, Gross JN, Haramati LB. Prevalence and characterization of asymptomatic pacemaker and ICD lead perforation on CT. Pacing Clin Electrophysiol PACE. 2007;30(1):28-32. doi:10.1111/j.1540-8159.2007.00575.x
DOI: doi.org/10.5114/aoms.2012.27284
4.
Rydlewska A, Małecka B, Zabek A, et al. Delayed perforation of the right ventricle as a complication of permanent cardiac pacing - is following the guidelines always the right choice? Non-standard treatment - a case report and literature review. Kardiol Pol. 2010;68(3):357-361.
DOI: doi.org/10.5114/aoms.2012.27284
5.
Vlay SC. Concerns about the Riata ST (St. Jude Medical) ICD lead. Pacing Clin Electrophysiol PACE. 2008;31(1):1-2. doi:10.1111/j.1540-8159.2007.00916.x
DOI: doi.org/10.1111/j.1540-8159.2007.00575.x
6.
Mahapatra S, Bybee KA, Bunch TJ, et al. Incidence and predictors of cardiac perforation after permanent pacemaker placement. Heart Rhythm. 2005;2(9):907-911. doi:10.1016/j.hrthm.2005.06.011
DOI: doi.org/10.1111/j.1540-8159.2007.00575.x
7.
Maziarz A, Ząbek A, Małecka B, Kutarski A, Lelakowski J. Cardiac chambers perforation by pacemaker and cardioverter-defibrillator leads. Own experience in diagnosis, treatment and preventive methods. Kardiol Pol. 2012;70(5):508-510.
8.
Akyol A, Aydin A, Erdinler I, Oguz E. Late perforation of the heart, pericardium, and diaphragm by an active-fixation ventricular lead. Pacing Clin Electrophysiol PACE. 2005;28(4):350-351. doi:10.1111/j.1540-8159.2005.09374.x
9.
Lau EW, Shannon HJ, McKavanagh P. Delayed cardiac perforation by defibrillator lead placed in the right ventricular outflow tract resulting in massive pericardial effusion. Pacing Clin Electrophysiol PACE. 2008;31(12):1646-1649. doi:10.1111/j.1540-8159.2008.01240.x
DOI: doi.org/10.1111/j.1540-8159.2007.00916.x
10.
Sassone B, Gabrieli L, Boggian G, Pilato E. Management of traumatic implantable cardioverter defibrillator lead perforation of the right ventricle after car accident: a case report. Eur Eur Pacing Arrhythm Card Electrophysiol J Work Groups Card Pacing Arrhythm Card Cell Electrophysiol Eur Soc Cardiol. 2009;11(7):961-962. doi:10.1093/europace/eup111
DOI: doi.org/10.1111/j.1540-8159.2007.00916.x
11.
Identification and management of right ventricular perforation using pacemaker and cardioverter-defibrillator leads: A case series and mini review - PMC. Accessed April 24, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300868/
DOI: doi.org/10.1016/j.hrthm.2005.02.238
12.
Balabanoff C, Gaffney CE, Ghersin E, Okamoto Y, Carrillo R, Fishman JE. Radiographic and electrocardiography-gated noncontrast cardiac CT assessment of lead perforation: modality comparison and interobserver agreement. J Cardiovasc Comput Tomogr. 2014;8(5):384-390. doi:10.1016/j.jcct.2014.08.004
DOI: doi.org/10.1016/j.hrthm.2005.06.011
13.
Nazarian S, Beinart R, Halperin HR. Magnetic resonance imaging and implantable devices. Circ Arrhythm Electrophysiol. 2013;6(2):419-428. doi:10.1161/CIRCEP.113.000116
14.
Banaszewski M, Stępińska J. Right heart perforation by pacemaker leads. Arch Med Sci AMS. 2012;8(1):11-13. doi:10.5114/aoms.2012.27273
15.
Sterliński M, Przybylski A, Maciag A, et al. Subacute cardiac perforations associated with active fixation leads. Eur Eur Pacing Arrhythm Card Electrophysiol J Work Groups Card Pacing Arrhythm Card Cell Electrophysiol Eur Soc Cardiol. 2009;11(2):206-212. doi:10.1093/europace/eun363
DOI: doi.org/10.1111/j.1540-8159.2005.09374.x

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Section CA LÂM SÀNG
Issue Số 117
Category BỆNH RỐI LOẠN NHỊP TIM
Pages 166-171

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