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Subacute right ventricle perforation: a pacemaker lead complication
  1. Emna Allouche1,2,
  2. Soumaya Chargui3,4,
  3. Marwa Fathi1 and
  4. Leila Bezdah1
  1. 1Cardiology Department, Charles Nicolle Hospital, Tunis, Tunisia
  2. 2Faculty of Medecine, University of Tunis El Manar, Tunis, Tunisia
  3. 3Internal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
  4. 4Research Laboratory of Renal Pathology LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia
  1. Correspondence to Dr Soumaya Chargui; chargui.souma{at}


Myocardial perforation is an uncommon but potentially life-threatening complication of pacemaker and implantable cardioverter-defibrillator. Myocardial perforation may be acute, subacute or chronic when it occurs within 24 hours of the device insertion; between 1 day and 30 days; and more than 30 days after implantation. This complication may occur in 1.7%–7% of patients. However, subacute myocardial perforation is rare and affects 0.5%–1.2% of patients. We report the case of an 85-year-old patient with a pacemaker failure 10 days after implantation due to a subacute myocardial perforation caused by an active fixation ventricular lead. Transthoracic echocardiography showed penetration of the ventricular lead through the right ventricular apex into the pericardium without any pericardial effusion. We confirmed myocardial perforation by a CT scan. We referred her to the surgery ward where she was successfully managed.

  • arrhythmias
  • pacing and electrophysiology

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  • Contributors EA managed the patient. EA and MF have given substantial contributions to the conception of the manuscript. SC participated in drafting the manuscript, LB revised it critically. All authors read and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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