Iatrogenic cardiac perforation due to pacing lead displacement: Imaging findings

PurposeCardiac perforations due to pacing and implantable defibrillator lead displacement are rare and their detection may be difficult. The goal of this study was to review the clinical and imaging presentation of cardiac perforation related to pacing lead displacement.Patients and methodsThe clinical and imaging files of four patients (two men and two women) who experienced cardiac perforation related to pacing lead displacement were reviewed. The four patients were investigated in our radiology department over a 24-month-period.ResultsTwo patients had clinical symptoms at the time lead displacement was detected and the other two were free of symptoms. In all patients, lead displacement was visible on imaging examinations in retrospect but was not detected prospectively.ConclusionRadiologists should pay attention to the position of the tips of the leads on chest X-ray and CT, even late after the implantation and in asymptomatic patients.