Unveiling a Critical Subacute Complication: Right Apical Septum Pacemaker Lead Dislodgement Leading to Right Ventricular Perforation and Minimal Pericardial Effusion

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 4; p. e57641
• Main Authors: Abouzeid, Wassim, Haddad, Ahmad W, Mirza, Noreen, Ahmed, Eyad, Correia, Joaquim, Suleiman, Addi
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 05-04-2024; Cureus
• Subjects: Asymptomatic; Cardiac arrhythmia; Cardiology; Case reports; Heart rate; Pacemakers; Patients; Pericardium; Tomography; Ultrasonic imaging; right ventricular perforation; pacemaker lead complication; pericardial effusion; pacemaker complication; sick sinus syndrome
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.57641

The implantation of cardiac pacing devices, such as pacemakers and implanted cardioverter-defibrillators (ICDs), has significantly improved patient outcomes in the treatment of a range of cardiac arrhythmias. Right ventricular (RV) pacing lead perforation is an uncommon but potentially dangerous complication that can occur despite technical breakthroughs. RV lead perforation, which can result in right ventricular perforation as well as possible pulmonary or vascular harm, is caused by the pacing lead breaking through the myocardial wall. Despite being rare, this complication warrants attention because of the risks for morbidity and mortality that are involved. We present a case of right ventricular perforation caused by a pacemaker lead and examine the nuances of RV lead perforation in this instance, including its prevalence, clinical presentation, diagnostic difficulties, and treatment strategies, illuminating the many factors to be taken into account while properly managing this issue.