Cardiac perforation with a passive fixation lead penetrating ventricular septum; report of a case]

A 81-year-old female developed diaphragm twitching 2 days after the intravenous implantation of pacemaker (DDD mode) with passive fixation leads. A computed tomography (CT) and fluoroscopy revealed the lead perforating the interventricular septum and the ventricular wall without any sign of pericardial effusion. Surgical procedure through median sternotomy was performed, and the penetrated lead was removed. The injured myocardium was repaired with a U stitch reinforced by Teflon-feltstrips. New epicardial leads were fixed on the right atrial wall and on the inferior wall of the right ventricle. The patient had been doing well until 86-year-old, when she died of myelodysplastic syndrome.