Very late and subacute right ventricular lead perforation presenting as cardiac tamponade

Abstract

Ventricular lead perforation (VLP) is a rare and life-threatening complication of permanent pacemakers. Generally, VLP emerges in acute and subacute periods after cardiac electronic devices are implanted. Late VLP is unexpected and occurs less frequently. There is an uncertain approach to the treatment of VLPs. Collaboration with cardiovascular surgeons is recommended. Herein, we present two cases of cardiac perforations who were successfully managed. One of them was admitted with cardiac tamponade four years after dual-chamber pacemaker (DCP) implantation, and the right ventricular lead was successfully removed with an open surgical method. The other was admitted with cardiac tamponade two weeks after DCP implantation. Ventricular lead was extracted by a simple traction method without surgical support and successfully re-implanted in the correct location.