CTICasesMyocardial Perforation by Pacemaker Lead with Insulation Disruption
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Imaging findings
Post-procedural chest radiographs showed a change in the position of the right ventricular pacemaker lead compared to intra-procedural images. Corresponding coronal CT confirmed perforation of the right ventricular myocardium by the lead. During attempted lead replacement, the suture sleeve was found to have completely disrupted the insulation and part of the conducting electrode, indicating lead damage.
Key takeaways
Pacemaker lead perforation is a critical complication that can be detected by changes in lead position on serial radiographs or confirmed by CT. Lead damage, such as insulation disruption, can occur during perforation and may necessitate full lead replacement.
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