Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Dec 2008
Case ReportsDelayed cardiac perforation by defibrillator lead placed in the right ventricular outflow tract resulting in massive pericardial effusion.
A 76-year-old man received a dual-chamber implantable cardioverter defibrillator (ICD), with the defibrillator lead positioned within the right ventricular outflow tract. The lead parameters at the time of implantation were satisfactory and the post-procedure chest X-ray showed the leads were in place. The patient was cardioverted from atrial fibrillation during defibrillation threshold testing and commenced on anticoagulation immediately. ⋯ Pericardiocentesis was performed and the defibrillator lead replaced with a different model positioned at the right ventricular apex. The patient made an uneventful recovery. The management and avoidance of delayed cardiac perforation by transvenous leads were discussed.