ICD-Electrode-Perforation of the Right Ventricle to the Pericardium with and without Pericardial Effusion

Author Info

Line Lisbeth Olesen

Corresponding Author

Line Lisbeth Olesen
Department of Cardiology, Zealand University Hospital, Roskilde, Denmark

A B S T R A C T

Two cases are described of iatrogenic traumatic perforation of an ICD electrode through the myocardium in the right ventricle and to the pericardium. The diagnostic gold standard gated CT was not necessary in either case. In the first case the lead insertion was difficult, time-consuming, and complicated by the PostCardiac Injury Syndrome and a slowly accumulating hemorrhagic pericardial effusion causing cardiac tamponade, diagnosed by the clinical picture, elevated CRP, ECG with low voltage and electrical alternans, chest X-ray revealing enlarged cardiac silhouette and echocardiography a large effusion, treated with pericardiocentesis and drainage. In the other case there was painful pericardial irritation and extracardiac pacing and ICD failure with loss of capture, no diagnostic changes in ECG, chest X-ray, and echocardiography; diagnosed by fluoroscopy during replacement at the lead, which went without complications and without pericardial effusion.

Article Info

Article Type

Case Report

Publication history

Received: Sat 30, May 2020
Accepted: Fri 12, Jun 2020
Published: Fri 19, Jun 2020

Copyright

© 2023 Line Lisbeth Olesen. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.RDI.2020.02.09