title: [Cardiac perforation as a late complication in a man with an implantable cardioverter-defibrillator].
abstract: A 55-year-old man with an implantable cardioverter-defibrillator (ICD) placed after diagnosis of Brugada syndrome 4 years earlier was admitted to hospital with dyspnea and a large left pleural effusion. After several episodes of cardiorespiratory arrest and application of advanced cardiac life support measures, an emergency sternotomy was performed. Cardiac and pleural perforation by the ICD lead was observed and the device was removed. Since the ICD was introduced in 1980, it has been effective in the treatment of malignant ventricular arrhythmias and in reducing the incidence of sudden death. Increased use, however, has meant a rise in the number of complications, some of which are potentially fatal. The rare complication we describe should therefore be considered whenever a patient with an ICD develops sudden respiratory failure or massive hemoptysis that cannot be explained by other causes.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de las Nieves, Granada. mcvidalca@hotmail.com
authors.forename: M C
authors.initials: MC
authors.lastname: Vidal
authors.forename: P
authors.initials: P
authors.lastname: Cuesta
authors.forename: E
authors.initials: E
authors.lastname: Vázquez
authors.forename: M
authors.initials: M
authors.lastname: Galán
authors.forename: C
authors.initials: C
authors.lastname: De la Cruz
authors.forename: E
authors.initials: E
authors.lastname: Haro
mesh_terms: D022561:Advanced Cardiac Life Support; D053840:Brugada Syndrome / Q000628:therapy; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006335:Heart Injuries / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000293:injuries*; D010996:Pleural Effusion / Q000209:etiology; D012121:Respiration, Artificial