Abstract
Background: Lead dislodgement has been shown to be the most common complication in
the first 30 days after pacemaker insertion. Although it is rare, pneumopericardium
with tamponade can also result. Objectives: We present a case of an extremely rare
delay from cardiac pacemaker insertion to lead migration with resulting pneumopericardium
and cardiac tamponade. Case Report: A 65-year-old woman with a past medical history
significant for congestive heart failure, chronic obstructive pulmonary disease, and
third-degree heart block, requiring pacemaker insertion 2 years prior with a revision
1 year prior, presented to the Emergency Department complaining of sudden-onset pleuritic
chest pain. Her work-up revealed a pneumopericardium with atrial pacemaker lead migration
into the right middle lobe of the lung. She suddenly developed hypotension and respiratory
distress and required pericardiocentesis and, ultimately, surgical repair for a perforated
right atrium. Conclusion: Pacemaker migration can lead to pneumopericardium and tamponade,
even up to 1 year after placement.
Keywords
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Article info
Publication history
Published online: June 14, 2010
Accepted:
April 10,
2010
Received in revised form:
January 9,
2010
Received:
October 15,
2009
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
