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Europace 2003 5(4):419-423; doi:10.1016/S1099-5129(03)00079-5
© 2003 by European Society of Cardiology
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CASE REPORT

Pericardial effusion and right-sided pneumothorax resulting from an atrial active-fixation lead

D. Dilling-Boer, H. Ector, R. Willems and H. Heidbüchel

Department of Cardiology, University Hospital Gasthuisberg, University of Leuven Leuven, Belgium

We report on a patient in whom an active-fixation pre-shaped atrial lead caused perforation of the right atrial wall, pericardium and pleura, resulting in pericardial effusion and right-sided pneumothorax. Chest X-ray did not demonstrate protrusion of the atrial lead outside the cardiac silhouette but computed tomography visualized the tip of the helix of the atrial screw-in electrode outside the contours of the right atrial appendage touching the right upper lobe of the lung. The lead was repositioned with resolution of pericardial effusion and pneumothorax. Due to their proximity to the right lung, high anterolaterally positioned atrial screw-in leads carry a small but definite risk for right-sided pneumothorax.

Key Words: Active fixation, atrial perforation, right pneumothorax, defibrillator, pacemaker

Correspondence: Hein Heidbüchel, MD, PhD, Cardiology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. Tel.: +32-16-34-42-48; Fax: +32-16-34-42-40. E-mail: hein.heidbuchel{at}uz.kuleuven.ac.be


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