TY - JOUR
AR - RDI-2020-2-109
TI - ICD-Electrode-Perforation of the Right Ventricle to the Pericardium with and without Pericardial Effusion
AU - Line Lisbeth, Olesen
JO - Radiology and Medical Diagnostic Imaging
PY - 2020
DA - Fri 19, Jun 2020
SN - 2613-7836
DO - http://dx.doi.org/10.31487/j.RDI.2020.02.09
UR - https://www.sciencerepository.org/icd-electrode-perforation-of-the-right-ventricle-to-the-pericardium_RDI-2020-2-109 
KW - ICD-electrode, cardiac perforation, cardiac tamponade, loss of capture, echocardiography, gated CT
AB - 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.