Akbarzadeh Mohammad Ali, Mollazadeh Reza, Sefidbakht Salma, Shahrzad Soraya, Bahrololoumi Bafruee Negar
Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Cardiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran.
J Arrhythm. 2017 Feb;33(1):1-5. doi: 10.1016/j.joa.2016.05.005. Epub 2016 Jun 30.
Right ventricular perforation is a rare but serious complication of permanent pacemaker and implantable cardioverter-defibrillator implantation, with a reported prevalence rate of 0.1-6%. Generally, there is a high incidence of asymptomatic lead perforation with otherwise normal function. Some patients present with a stabbing chest pain and shortness of breath or pacemaker malfunction. However, in some cases, tamponade or adjacent tissue injury may be seen. The exact risk factors for lead perforation are not yet clear. Furthermore, there are many controversies in the management of lead perforation. Extraction of an asymptomatic, incidentally detected, chronically perforating lead does not seem to be necessary. Patients with symptoms or device malfunction will require treatment appropriate for their problem.
右心室穿孔是永久性起搏器和植入式心脏复律除颤器植入术罕见但严重的并发症，报道的发生率为0.1%-6%。一般来说，功能正常但无症状的导线穿孔发生率较高。一些患者表现为刺痛性胸痛、呼吸急促或起搏器功能障碍。然而，在某些情况下，可能会出现心包填塞或邻近组织损伤。导线穿孔的确切危险因素尚不清楚。此外，导线穿孔的处理存在许多争议。对于偶然检测到的无症状慢性穿孔导线，似乎没有必要取出。有症状或设备故障的患者需要针对其问题进行适当治疗。
