Delayed Lead Perforation: Can We Ever Let the Guard Down?

• Published in: Cardiology Research and Practice Vol. 2010; no. 2010; pp. 185 - 188
• Main Authors: Alla, Venkata M., Reddy, Yeruva M., Abide, William, Hee, Tom, Hunter, Claire
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Limiteds 01-01-2010; Hindawi Puplishing Corporation; SAGE-Hindawi Access to Research; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Cardiac patients; Care and treatment; Case Report; Case studies; Complications and side effects; Equipment and supplies; Fainting; Pacemaker, Artificial (Heart); United States
• ISSN: 2090-0597; 2090-8016; 2090-0597
• DOI: 10.4061/2010/741751

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.