Pneumopericardium and pneumothorax after permanent pacemaker implantation.

Abstract

We present a patient with chronic obstructive pulmonary disease who developed discomfort 2 days after dual-chamber pacemaker implantation via the left cephalic vein approach. The pacer was placed with active-fixation leads without obvious complications. A computed tomography (CT) scan taken in the emergency room showed right pneumothorax and associated pneumopericardium without pneumomediastinum. A three-dimensional reconstruction of CT images confirmed the atrial lead protruding into the pleural space. This lead likely ruptured a bulla causing a pneumothorax followed by pneumopericardium through a pleuro-pericardial communication. Chest tube placement relieved both pneumothorax and pneumopericardium without the need for atrial lead extraction.

• Authors: Clifford C Sebastian, Wen-Chih Wu, Mark Shafer, Gaurav Choudhary, Pranav M Patel
• Journal: Pacing and clinical electrophysiology : PACE (Pacing Clin Electrophysiol) Vol. 28 Issue 5 Pg. 466-8 (May 2005) ISSN: 0147-8389 [Print] United States
• PMID: 15869684 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Humans
• Male
• Pacemaker, Artificial (adverse effects)
• Pneumopericardium (etiology)
• Pneumothorax (etiology)
• Prosthesis Implantation