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Right ventricular lead perforation with iatrogenic injury to an intercostal artery causing haemothorax after pacemaker implant
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Cardiology.ORCID iD: 0000-0002-4288-3310
Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Radiology and Medical Physics.ORCID iD: 0000-0002-1346-1450
Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
2024 (English)In: BMJ Case Reports, E-ISSN 1757-790X, Vol. 17, no 2, article id e258314Article in journal (Refereed) Published
Abstract [en]

A woman in her 80s experienced a life-threatening complication of pacemaker implant consisting of subacute right ventricular lead perforation causing iatrogenic injury to an intercostal artery, resulting in a large haemothorax. A CT scan confirmed active bleeding from the fourth intercostal artery. The patient underwent cardiothoracic surgery via a median sternotomy approach, during which the source of the bleeding was sealed, a new epicardial lead was positioned, and the original lead was extracted. This case emphasises the potentially severe consequences of pacemaker lead perforation and secondary injury to adjacent structures. It underscores the importance of early recognition and timely intervention, preferably in a tertiary specialist unit equipped for cardiothoracic surgery and confirms the value of pacemaker interrogation and CT scans for diagnosis.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024. Vol. 17, no 2, article id e258314
Keywords [en]
Cardiothoracic surgery, Pacing and electrophysiology, Radiology (diagnostics)
National Category
Surgery Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:oru:diva-111493DOI: 10.1136/bcr-2023-258314ISI: 001159177500002PubMedID: 38331446Scopus ID: 2-s2.0-85184706547OAI: oai:DiVA.org:oru-111493DiVA, id: diva2:1836507
Available from: 2024-02-09 Created: 2024-02-09 Last updated: 2024-02-20Bibliographically approved

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Björkenheim, AnnaLidén, Mats

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