CTICasesAtrial Pacemaker Lead Perforation
Imaging findings
Chest radiograph and CT show a newly placed right atrial pacemaker lead projecting beyond the expected margin of the right atrial appendage, associated with a new right-sided hydropneumothorax.
Key takeaways
Transmyocardial lead perforation is an uncommon complication of pacemaker or ICD placement, most frequently involving the thin right atrial appendage. Presenting features include chest pain, lead malfunction, and pneumothorax or hemothorax from localized pleural violation.
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