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. 2020 Oct 6;6(1):262.
doi: 10.1186/s40792-020-00999-3.

Erosion of a right ventricular pacer lead into the left chest wall

Michael J Herr  1   2 , J Macy Cottrell  3 , H Edward Garrett Jr  4 , Darryl S Weiman  4
Affiliations

Erosion of a right ventricular pacer lead into the left chest wall

Michael J Herr et al. Surg Case Rep. .

Abstract

Background: Erosion of a pacer lead into the chest wall may result in pericardial effusion with cardiac tamponade. Free rupture into the pleura or mediastinum can result in hypotension and cardiac arrest.

Case presentation: We report a unique case of a right ventricular pacer lead which eroded through the right ventricle into the left chest wall and penetrated a rib. The patient presented with a tender chest wall mass without pericardial or pleural effusion. The segment of rib which the pacing lead had penetrated was removed.

Conclusions: The patient tolerated the procedure well and was discharged 1 week after the operation. This case adds to the current literature the justification of removal of temporary and non-functional pacing leads.

Keywords: Chest wall; Pacing lead; Rib perforation.

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Conflict of interest statement

HEG receives patent royalties/licensing fees Garrett, Bromet for sternal closure device not used or described in this report. MJH, JMC, and DSW have no competing interests.

Figures

Fig. 1
Fig. 1
a Sagittal CT noting the ventricular lead rib perforation and anterior chest wall mass and b thoracic CT imaging the left anterior chest wall mass and erosion of ventricular pace lead into a rib
Fig. 2
Fig. 2
a Open thoracotomy view of the non-functional pace lead emerging through the fourth rib indicated with arrow and b removed portion of rib demonstrating erosion from pacing lead
See this image and copyright information in PMC

References

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