Rao Abhinav K, Herrforth Craig, Patel Angeli, Patel Kunaal, Lyons Brittany
Internal Medicine, Trident Medical Center, North Charleston, USA.
Cureus. 2024 Jan 29;16(1):e53146. doi: 10.7759/cureus.53146. eCollection 2024 Jan.
The implantation of an implantable cardioverter defibrillator (ICD) carries a risk for major complications, one of which is ventricular free wall rupture secondary to a lead perforation. This known complication, although rare, has estimated incidence rates between 0.1% and 3%. Predictive factors of such an event include temporary leads, steroid use, active fixation leads, low body mass index (<20 kg/m), age greater than 80 years, female gender, and concurrent anticoagulation. Right ventricular systolic pressure >35 mmHg is considered a protective factor likely due to associated right ventricular hypertrophy. We present a case of a 73-year-old female with a history of aortic stenosis status post-transcatheter aortic valve replacement (TAVR) and atrial fibrillation (AFib) who met the criteria for an ICD after suffering ventricular fibrillation arrest (after TAVR procedure) ultimately resulting in lead perforation.
植入式心脏复律除颤器（ICD）的植入存在发生严重并发症的风险，其中之一是因导线穿孔继发心室游离壁破裂。这种已知的并发症虽然罕见，但其估计发生率在0.1%至3%之间。此类事件的预测因素包括临时导线、使用类固醇、主动固定导线、低体重指数（<20 kg/m²）、年龄大于80岁、女性以及同时进行抗凝治疗。右心室收缩压>35 mmHg被认为是一个保护因素，可能是由于相关的右心室肥厚。我们报告一例73岁女性病例，该患者有主动脉瓣狭窄病史，行经导管主动脉瓣置换术（TAVR）后及心房颤动（AFib），在发生心室颤动骤停（TAVR术后）后符合植入ICD的标准，最终导致导线穿孔。
