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Europace 2003 5(4):361-363; doi:10.1016/S1099-5129(03)00093-X
© 2003 by European Society of Cardiology
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CASE REPORT

Pneumopericardium and pneumothorax contralateral to venous access site after permanent pacemaker implantation

K. Srivathsan, R. A. Byrne, C. P. Appleton and L. R. P. Scott

Division of Cardiovascular Diseases, Mayo Clinic Scottsdale Phoenix AZ, USA

A 77-year-old female underwent implantation of a left-sided dual chamber permanent pacemaker for symptomatic bradycardia with active fixation leads. Eight hours after the procedure, the patient complained of shortness of breath and was found to have a 30% right pneumothorax on chest X-ray. Immediately, a chest tube was inserted, promptly relieving the symptoms. A CT scan of the chest revealed extrusion of the helix of the screw-in atrial lead, through the wall of the right atrial appendage. The helix was abutting a bulla in the right lung, the likely cause for pneumothorax and pneumopericardium. The atrial lead was explanted without incident.

Key Words: Contralateral pneumothorax, dual chamber permanent pacemaker, pacemaker insertion complications

Correspondence: Luis R. P. Scott, MD, Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, U.S.A. Tel.: +1-480-342-1398; Fax: +1-480-342-1388. E-mail: scott.luis{at}mayo.edu


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