Late asymptomatic atrial lead perforation, a fortuitous finding during lead extraction using thoracoscopic surveillance: a case report and review of the literature
- Resource Type
- Authors
- Berry M. van Gelder; Frank A. Bracke; Niels Verberkmoes; Roy Nathoe
- Source
- Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 18(12)
- Subject
- Male
medicine.medical_specialty
Pacemaker, Artificial
Perforation (oil well)
Adhesion (medicine)
Dissection (medical)
030204 cardiovascular system & hematology
Asymptomatic
03 medical and health sciences
0302 clinical medicine
Physiology (medical)
medicine
Humans
cardiovascular diseases
Heart Atria
Device Removal
Lung
business.industry
Thoracic Surgery, Video-Assisted
Lung Injury
Middle Aged
medicine.disease
Surgery
Atrial Lead
Radiography
medicine.anatomical_structure
030228 respiratory system
cardiovascular system
Right atrium
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Lead extraction
- Language
- ISSN
- 1532-2092
A 61-year-old male patient was referred for lead extraction of an infected two-chamber pacemaker system first implanted 18 years ago. A new atrial lead was implanted 9 years later because of loss of capture of the original lead. Video-assisted thoracoscopic surgery (VATS) that we use in high-risk cases showed extensive fibrous adhesion between the right atrium wall and the right lung. Dissection of the adhesion revealed the presence of an atrial lead perforated into the lung. After cutting off the lead tip, the residual lead was removed endovascularly from the subclavian site. A literature review of 25 reported cases of late atrial lead perforation was added to the findings in our case report.