Kagawa S, Matsumoto K, Kodama Y, Ito S, Fujiwara R, Shiroyama Y, Kajio K, Kasamatsu K, Murata E, Kawase Y. Persistent iatrogenic muscular ventricular septal lead perforation after pacemaker implantation using
delivery sheath system.
J Cardiol Cases 2024;
29:82-84. [PMID:
38362577 PMCID:
PMC10865116 DOI:
10.1016/j.jccase.2023.10.013]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 10/05/2023] [Accepted: 10/16/2023] [Indexed: 02/17/2024] Open
Abstract
Ventricular septal perforation is a rare complication of pacemaker implantation. Here, we describe the case of a 69-year-old man with complete atrioventricular block and heart failure. The right ventricular pacemaker was implanted with a long pre-shaped delivery sheath. A new systolic murmur appeared after the procedure. Transthoracic echocardiography revealed a ventricular septal perforation, with a Qp/Qs of 1.09, which was a small shunt rate and required no intervention. The persistent ventricular septal perforation was observed, and the shunt rate remained at 8-month follow-up.
Learning objective
Ventricular septal lead perforation (VSP) is a rare complication of pacemaker implantation. Although iatrogenic VSP generally close spontaneously without adverse clinical outcomes, clinicians should pay attention to the possibility of its persistence.
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