DÄ internationalArchive14/2018Chest Pain Due to Pacemaker Lead Perforation

Clinical Snapshot

Chest Pain Due to Pacemaker Lead Perforation

Dtsch Arztebl Int 2018; 115: 242. DOI: 10.3238/arztebl.2018.0242

Christ, M; Grett, M; Trappe, H

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Chest Pain Due to Pacemaker Lead Perforation
Chest Pain Due to Pacemaker Lead Perforation
Figure
Chest Pain Due to Pacemaker Lead Perforation

An 85-year-old woman presented complaining of chest pain one week after discharge from another hospital, where she had undergone the placement of a dual-chamber pacemaker to treat sick sinus syndrome. An ECG on admission revealed atrial fibrillation with ventricularly stimulated ventricular complexes and a heart rate of 72 beats per minute. There were no specific abnormalities on physical examination. A chest x-ray revealed dislocation of the ventricular lead, with its tip outside the cardiac silhouette. A clinically significant pericardial effusion was ruled out by echocardiography, and computed tomography confirmed that the lead tip lay in the mediastinum (Figure). The ventricular lead was repositioned uneventfully; preparations had been made for immediate cardiac surgical intervention as needed, but this was, fortunately, unnecessary.

Dr. med. Martin Christ, Dr. med. Martin Grett, Prof. Dr. med. Hans-Joachim Trappe, Medizinische Klinik II, Schwerpunkt Kardiologie und Angiologie, Marien Hospital Herne, Ruhr-Universität Bochum, martin.christ@elisabethgruppe.de

Conflict of interest statement: The authors state that they have no conflict of interest.

Cite this as: Christ M, Grett M, Trappe HJ: Chest pain due to pacemaker lead perforation. Dtsch Arztebl Int 2018; 115: 242. DOI: 10.3238/arztebl.2018.0242

Translated from the original German by Ethan Taub, M.D.

Chest Pain Due to Pacemaker Lead Perforation
Chest Pain Due to Pacemaker Lead Perforation
Figure
Chest Pain Due to Pacemaker Lead Perforation