title: Delayed lead perforation: a rare cause of pacemaker dysfunction.
abstract: A 65-year-old woman with a dual-chamber pacemaker implanted in 2006 for symptomatic carotid sinus hypersensitivity was incidentally found to have loss of ventricular capture on routine pacemaker interrogation. A chest X-ray raised the suspicion of perforation and migration of the right ventricular lead, confirmed by three-dimensional echocardiogram and CT scan. On the basis of this case, we review myocardial lead perforation, including predisposing factors, pathophysiological mechanisms, diagnostic approach and therapeutic options.
authors.affiliation: Serviço de Cardiologia, Hospital São Teotónio, E.P.E., Viseu, Portugal. luisferreirasantos@gmail.com
authors.forename: Luís Ferreira
authors.initials: LF
authors.lastname: dos Santos
authors.forename: Filipa
authors.initials: F
authors.lastname: Costa
authors.forename: Emanuel
authors.initials: E
authors.lastname: Correia
authors.forename: Bruno
authors.initials: B
authors.lastname: Rodrigues
authors.forename: Davide
authors.initials: D
authors.lastname: Moreira
authors.forename: Hugo
authors.initials: H
authors.lastname: Correia
authors.forename: Luís
authors.initials: L
authors.lastname: Nunes
authors.forename: João
authors.initials: J
authors.lastname: Pipa
authors.forename: António
authors.initials: A
authors.lastname: Costa
authors.forename: Lopes
authors.initials: L
authors.lastname: de Carvalho
authors.forename: Costa
authors.initials: C
authors.lastname: Cabral
authors.forename: Nuno
authors.initials: N
authors.lastname: Ribeiro
authors.forename: Ramos
authors.initials: R
authors.lastname: de Olival
authors.forename: Oliveira
authors.initials: O
authors.lastname: Santos
mesh_terms: D000368:Aged; D004868:Equipment Failure; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis* / Q000209:etiology*; D006335:Heart Injuries / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D010138:Pacemaker, Artificial