The Subtle Journey of a Right Atrial Lead: Hemopneumothorax Due to Subacute Pacemaker Lead Perforation

Carola Gianni; Robert C Canby; Alisara Anannab; Domenico G Della Rocca; Andrea Natale; Amin Al-Ahmad

doi:10.1016/j.jaccas.2020.05.018

The Subtle Journey of a Right Atrial Lead: Hemopneumothorax Due to Subacute Pacemaker Lead Perforation

JACC Case Rep. 2020 Jun 17;2(6):902-906. doi: 10.1016/j.jaccas.2020.05.018. eCollection 2020 Jun.

Authors

Carola Gianni¹, Robert C Canby¹, Alisara Anannab^{1

2}, Domenico G Della Rocca¹, Andrea Natale^{1

3

4

5}, Amin Al-Ahmad¹

Affiliations

¹ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
² Electrophysiology Unit, Department of Cardiovascular and Intervention, Central Chest Institute of Thailand, Nonthaburi, Thailand.
³ HCA National Medical Director of Cardiac Electrophysiology.
⁴ Interventional Electrophysiology, Scripps Clinic, La Jolla, California.
⁵ MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.

Abstract

We report an unusual case of subacute right atrial perforation by a screw-in pacemaker lead that migrated into the right lung causing hemopneumothorax 2 weeks after the procedure. After transvenous simple manual traction and minithoracotomy repair of the right atrial wall, the lead was repositioned without any complications. (Level of Difficulty: Beginner.).

Keywords: CT, computed tomography; CXR, chest x-ray; ED, emergency department; atrial lead; cardiac pacemaker; hemothorax; perforation.

Publication types

Case Reports