Hubert James, Irvine Dylan S, Thornton Imani
Anesthesiology, HCA Florida Westside Hospital, Plantation, USA.
Anesthesiology and Critical Care, HCA Florida Westside Hospital, Plantation, USA.
Cureus. 2024 Sep 9;16(9):e68996. doi: 10.7759/cureus.68996. eCollection 2024 Sep.
Automatic implantable cardioverter defibrillator (AICD) lead perforation is a rare but potentially life-threatening complication. AICD lead perforations are rare, occurring in approximately 0.1%-0.8% of patients, most commonly within 24 hours of the implantation. ICD lead perforations can be acute (within 24 hours of implantation), subacute (between day 1 and day 30), or delayed (>30 days postimplantation). Delayed lead perforations are rare compared to acute and subacute lead perforations and are not as well-studied because patients are often asymptomatic and are not diagnosed. Here, we report the case of a 44-year-old male who presented to the emergency department with pleuritic chest pain and dyspnea one-month status-post dual-chamber AICD. The patient demonstrated signs and symptoms of cardiac tamponade, which was confirmed with a 2D echocardiogram and computed tomography (CT) scans. Emergency pericardiocentesis was performed under general anesthesia, which restored hemodynamic stability. The right ventricular lead was repositioned and a pericardial drain was placed. The patient remained in the intensive care unit (ICU) for three days and was discharged to home on postoperative day 8.
植入式自动心脏复律除颤器（AICD）导线穿孔是一种罕见但可能危及生命的并发症。AICD导线穿孔很少见，约0.1%-0.8%的患者会发生，最常见于植入后24小时内。ICD导线穿孔可分为急性（植入后24小时内）、亚急性（第1天至第30天之间）或延迟性（植入后>30天）。与急性和亚急性导线穿孔相比，延迟性导线穿孔较为罕见，且由于患者通常无症状而未被诊断，因此研究也不够充分。在此，我们报告一例44岁男性患者，在植入双腔AICD一个月后因胸膜炎性胸痛和呼吸困难就诊于急诊科。患者表现出心脏压塞的体征和症状，经二维超声心动图和计算机断层扫描（CT）证实。在全身麻醉下进行了紧急心包穿刺术，恢复了血流动力学稳定性。重新调整了右心室导线并放置了心包引流管。患者在重症监护病房（ICU）住院三天，术后第8天出院回家。
