Pneumopericardium and pneumothorax contralateral to venous access site after permanent pacemaker implantation.
A 77-year-old female underwent implantation of a left-sided dual chamber permanent pacemaker for symptomatic bradycardia with active fixation leads. Eight hours after the procedure, the patient complained of shortness of breath and was found to have a 30% right pneumothorax on chest X-ray. Immediately, a chest tube was inserted, promptly relieving the symptoms. A CT scan of the chest revealed extrusion of the helix of the screw-in atrial lead, through the wall of the right atrial appendage. The helix was abutting a bulla in the right lung, the likely cause for pneumothorax and pneumopericardium. The atrial lead was explanted without incident.
Srivathsan
K
K
Division of Cardiovascular Diseases, Mayo Clinic Scottsdale, Phoenix, AZ 85054, USA.
Byrne
R A
RA
Appleton
C P
CP
Scott
L R P
LR
D000368:Aged; D020517:Atrial Appendage / Q000293:injuries; D004567:Electrodes, Implanted / Q000009:adverse effects; D005260:Female; D006335:Heart Injuries / Q000209:etiology*; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011026:Pneumopericardium / Q000209:etiology*; D011030:Pneumothorax / Q000209:etiology*; D014057:Tomography, X-Ray Computed