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Late Perforation by Cardiac Implantable Electronic Device Leads: Clinical Presentation, Diagnostic Clues, and Management
Marwan M. Refaat MD,
Jana G. Hashash MD,
Alaa A. Shalaby MD,
Marwan M. Refaat MD
Division of Cardiology, VA Pittsburgh Healthcare System and the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Search for more papers by this authorJana G. Hashash MD
Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Search for more papers by this authorCorresponding Author
Alaa A. Shalaby MD
Division of Cardiology, VA Pittsburgh Healthcare System and the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
VA Pittsburgh Healthcare System University Drive Division, 111C-U Pittsburgh, PA 15240.Search for more papers by this authorMarwan M. Refaat MD,
Jana G. Hashash MD,
Alaa A. Shalaby MD,
Marwan M. Refaat MD
Division of Cardiology, VA Pittsburgh Healthcare System and the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Search for more papers by this authorJana G. Hashash MD
Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Search for more papers by this authorCorresponding Author
Alaa A. Shalaby MD
Division of Cardiology, VA Pittsburgh Healthcare System and the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
VA Pittsburgh Healthcare System University Drive Division, 111C-U Pittsburgh, PA 15240.Search for more papers by this authorAbstract
Late intracardiac lead perforation is defined as migration and perforation of an implanted lead after 1 month of cardiac electronic device implantation. It is an under-recognized complication with significant morbidity and mortality, particularly if not recognized early. Two patients with late perforation caused by passive-fixation leads are reported and the clinical features of their presentation and management are reviewed. We conducted a thorough review of the available English language literature pertaining to this complication to draw relevant conclusions regarding presentation, diagnosis, and management. Early recognition of this complication is important as the indications for and numbers of patients who receive cardiac implantable electronic devices continue to expand. Copyright © 2010 Wiley Periodicals, Inc.
The authors have no funding, financial relationships, or conflicts of interest to disclose.
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