CTICasesPacemaker Lead Perforation
Imaging findings
Serial chest radiographs and CT chest demonstrate that a right ventricular/atrial pacemaker lead has changed position, curving inferiorly and laterally, and perforated the right atrial free wall into the pericardial space, associated with a new pericardial effusion.
Key takeaways
Pacemaker or ICD lead perforation is a known complication that can occur acutely or chronically. Serial chest radiographs are useful to detect changes in lead tip position and curvature. Perforation is often associated with pericardial effusion, chest pain, or lead malfunction.
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