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Review
. 2016 Dec;18(12):1773-1778.
doi: 10.1093/europace/euw054. Epub 2016 Jun 2.

Late asymptomatic atrial lead perforation, a fortuitous finding during lead extraction using thoracoscopic surveillance: a case report and review of the literature

Berry M Van Gelder  1 , Niels Verberkmoes  2 , Roy Nathoe  3 , Frank A Bracke  3
Affiliations
Review

Late asymptomatic atrial lead perforation, a fortuitous finding during lead extraction using thoracoscopic surveillance: a case report and review of the literature

Berry M Van Gelder et al. Europace. 2016 Dec.

Abstract

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.

Keywords: Atrial lead perforation; Bleeding control; Lead extraction; Video-assisted thoracospic surgery (VATS).

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