Contralateral pneumothorax after endocardial dual-chamber pacemaker implantation resulting from atrial lead perforation.
We describe the occurrence of a right-sided pneumothorax following a left-sided dual chamber pacemaker implantation, due to a perforation of the screw of the J-shaped active-fixation lead through the right atrial wall. A review of the literature regarding complications of different atrial lead types (passive vs. active and J-shape vs. straight) is provided. Current data suggest that passive-fixation leads could have an advantage, provided they can be positioned satisfactorily because of the lower risk of pericardial complications. If active-fixation leads are used, straight leads might be preferable above J-shaped leads because of the lower rate of perforation.
Van Herendael
Hugo
H
St. Michael's Hospital, Division of Cardiology, University of Toronto, Toronto, Canada. VanHerendaelH@smh.toronto.on.ca
Willems
Rik
R
D000368:Aged; D054537:Atrioventricular Block / Q000628:therapy; D020878:Device Removal / Q000379:methods; D003937:Diagnosis, Differential; D004567:Electrodes, Implanted / Q000009:adverse effects; D005500:Follow-Up Studies; D006325:Heart Atria / Q000293:injuries*; D006335:Heart Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D019919:Prosthesis Implantation / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed