Lees D A, Green G D
Thorax. 1977 Jun;32(3):370-2. doi: 10.1136/thx.32.3.370.
One of the hazards of endocardial cardiac pacing is that the pacemaker lead may perforate the myocardial wall or interventricular septum although the incidence of such perforations is believed to be small. This paper describes what is believed to be a unique case in which a pacemaker lead perforated the atrial wall at implantation (or possibly shortly afterwards) and yet gave satisfactory right ventricular epicardial pacing for more than five years. The perforation was discovered during a routine postmortem examination but earlier lateral x-ray examinations would probably have identified the abnormal position of the electrodes. Moreover, the present implantation technique would not have allowed perforation of the atrial wall at implantation to go undetected.
心内膜心脏起搏的风险之一是起搏器电极可能会穿透心肌壁或室间隔，尽管据信这种穿孔的发生率很低。本文描述了一个据信独一无二的病例，在该病例中，一个起搏器电极在植入时（或可能在植入后不久）穿透了心房壁，但却提供了超过五年的令人满意的右心室心外膜起搏。穿孔是在一次常规尸检中发现的，但早期的侧位X线检查可能已经能确定电极的异常位置。此外，目前的植入技术不会让植入时心房壁的穿孔未被发现。
