CTICasesRight Ventricular Lead Perforation
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Imaging findings
Chest x-rays show acute angulation of the distal AICD lead, which suggests abnormality. Subsequent CT confirms the right ventricular lead is perforated, extending outside the right ventricular myocardium, through the epicardial fat, and beyond the pericardium.
Key takeaways
Acute angulation of an intracardiac lead on chest x-ray is a strong indicator of lead perforation. Cardiac CT can definitively confirm the lead's extra-myocardial position. Changes in impedance readings or device malfunction may also indicate perforation.
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