Heart perforation in patients with permanent cardiac pacing : pilot personal observations

2012
journal article
article
25
dc.abstract.enIntroduction: Heart perforation is a rare complication of pacemaker (PM)/im plantable cardioverter-defibrillator (ICD) implantation. Material and methods: In our clinic in 2005-2010, 6 patients with heart perforation were hospitalized (3 women, 3 men), mean age 58.6 ±20.8 years (17 to 73 years). The indication to PM/ICD implantation was tachy-brady syndrome in 3 cases, second-degree atrioventricular block, advanced with losses of consciousness, vaso-vagal syndrome type II B with asystole lasting 12 s and recurrent non-sustained ventricular tachycardia in 1 patient. We analyzed patient’s medical records, X-rays, echocardiography, computed tomography (CT) and procedure protocols. Results: The incidence of heart perforation was 0.09%. Symptoms developed 4 to 990 days (mean 186.3 ±394.3) after PM/ICD implantation. The perforation site was found in the right atrial wall in 1 cases and the right ventricular wall in 6 cases. The TTE revealed an accumulation of fluid in the pericardium over 10 mm behind the posterior wall of the left ventricle in all patients. The CT scan confirmed perforation of the heart chambers (atrium and in 6 cases ventricle). In 5 cases the whole device was removed by direct traction or percutaneous lead extraction with pericardiocentesis when necessary (pericardium drainage in 3 cases) while in 1 case cardiac surgery was needed. Conclusions: The perforating lead may be removed by direct traction in the operating room with cardiosurgical, anesthesiological and echocardiographical backup. In case of the lead perforation outside the pericardial sac or its atypical location, cardiac surgery is a safer method. The most important diagnostic method remains computed tomographypl
dc.affiliationWydział Lekarski : Instytut Kardiologiipl
dc.contributor.authorPiekarz, Justynapl
dc.contributor.authorLelakowski, Jacek - 130641 pl
dc.contributor.authorRydlewska, Anna - 141005 pl
dc.contributor.authorMajewski, Jacek - 130798 pl
dc.date.accessioned2020-04-14T06:52:29Z
dc.date.available2020-04-14T06:52:29Z
dc.date.issued2012pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.number1pl
dc.description.physical70-74pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume8pl
dc.identifier.doi10.5114/aoms.2012.27284pl
dc.identifier.eissn1896-9151pl
dc.identifier.issn1734-1922pl
dc.identifier.projectROD UJ / OPpl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/153754
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Na tych samych warunkach 4.0 Międzynarodowa*
dc.rights.licenceCC-BY-NC-SA
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/legalcode.pl*
dc.share.typeotwarte czasopismo
dc.subject.enheart perforationpl
dc.subject.enpacemaker/cardioverter-defibrillator implantationpl
dc.subtypeArticlepl
dc.titleHeart perforation in patients with permanent cardiac pacing : pilot personal observationspl
dc.title.journalArchives of Medical Sciencepl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.enpl
Introduction: Heart perforation is a rare complication of pacemaker (PM)/im plantable cardioverter-defibrillator (ICD) implantation. Material and methods: In our clinic in 2005-2010, 6 patients with heart perforation were hospitalized (3 women, 3 men), mean age 58.6 ±20.8 years (17 to 73 years). The indication to PM/ICD implantation was tachy-brady syndrome in 3 cases, second-degree atrioventricular block, advanced with losses of consciousness, vaso-vagal syndrome type II B with asystole lasting 12 s and recurrent non-sustained ventricular tachycardia in 1 patient. We analyzed patient’s medical records, X-rays, echocardiography, computed tomography (CT) and procedure protocols. Results: The incidence of heart perforation was 0.09%. Symptoms developed 4 to 990 days (mean 186.3 ±394.3) after PM/ICD implantation. The perforation site was found in the right atrial wall in 1 cases and the right ventricular wall in 6 cases. The TTE revealed an accumulation of fluid in the pericardium over 10 mm behind the posterior wall of the left ventricle in all patients. The CT scan confirmed perforation of the heart chambers (atrium and in 6 cases ventricle). In 5 cases the whole device was removed by direct traction or percutaneous lead extraction with pericardiocentesis when necessary (pericardium drainage in 3 cases) while in 1 case cardiac surgery was needed. Conclusions: The perforating lead may be removed by direct traction in the operating room with cardiosurgical, anesthesiological and echocardiographical backup. In case of the lead perforation outside the pericardial sac or its atypical location, cardiac surgery is a safer method. The most important diagnostic method remains computed tomography
dc.affiliationpl
Wydział Lekarski : Instytut Kardiologii
dc.contributor.authorpl
Piekarz, Justyna
dc.contributor.authorpl
Lelakowski, Jacek - 130641
dc.contributor.authorpl
Rydlewska, Anna - 141005
dc.contributor.authorpl
Majewski, Jacek - 130798
dc.date.accessioned
2020-04-14T06:52:29Z
dc.date.available
2020-04-14T06:52:29Z
dc.date.issuedpl
2012
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
1
dc.description.physicalpl
70-74
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
8
dc.identifier.doipl
10.5114/aoms.2012.27284
dc.identifier.eissnpl
1896-9151
dc.identifier.issnpl
1734-1922
dc.identifier.projectpl
ROD UJ / OP
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/153754
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Na tych samych warunkach 4.0 Międzynarodowa
dc.rights.licence
CC-BY-NC-SA
dc.rights.uri*
http://creativecommons.org/licenses/by-nc-sa/4.0/legalcode.pl
dc.share.type
otwarte czasopismo
dc.subject.enpl
heart perforation
dc.subject.enpl
pacemaker/cardioverter-defibrillator implantation
dc.subtypepl
Article
dc.titlepl
Heart perforation in patients with permanent cardiac pacing : pilot personal observations
dc.title.journalpl
Archives of Medical Science
dc.typepl
JournalArticle
dspace.entity.type
Publication

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