Retrospective analysis on the clinical features and management of acute and subacute right ventricular perforation by pacemaker lead
10.3760/cma.j.issn.0253-3758.2013.10.011
- VernacularTitle:急性和亚急性导线穿孔七例的临床特征与处理
- Author:
Yan DAI
1
;
Ke-Ping CHEN
;
Wei HUA
;
Jie-Lin PU
;
Xiao-Qing REN
;
Shu ZHANG
Author Information
1. 100037,国家心血管病中心中国医学科学院北京协和医学院阜外心血管病医院心律失常中心
- Keywords:
Pacemaker,artificial;
Intraoperative,complications;
Postoperative,complications
- From:
Chinese Journal of Cardiology
2013;41(10):862-865
- CountryChina
- Language:Chinese
-
Abstract:
Objective To describe the clinical characteristics and management of the acute and subacute cardiac perforation by pacing leads.Methods We retrospectively analyzed clinical data of patients with acute and subacute right ventricular perforation by pacemaker lead occurred in our hospital between 2006 and 2011.Results Seven cases of confirmed acute and subacute right ventricular perforation by pacemaker lead were enrolled.The perforation rate was 0.15％,2 cases of perforation occurred during the procedure.The main manifestation was low blood pressure and pericardial effusion.These two patients with cardiac tamponade underwent urgent percutaneous pericardiocentesis and patients recovered without complication.The remaining 5 cases of perforation occurred within 4-16 days after the pacemaker implantation.The main symptoms were diaphragm stimulation and chest pain.Signs of leads dysfunction were observed in all 5 patients.The diagn,osis of cardiac perforation was confirmed by chest X-ray,echocardiography,or computed tomography.In all these 5 patients,the leads were removed by simple traction under fluoroscopic guidance with surgical backup support,no complication was observed.Conclusion Acute and subacute right ventricular perforation is a rare but serious complication of pacemaker implantation.In most patients,the leads can be safely removed under fluoroscopic guidance with surgical backup support and close monitoring.
