{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:21:34Z","timestamp":1790788894086,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T00:00:00Z","timestamp":1600732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cardiac perforation is a rare complication of cardiac implantable electronic device (CIED) implantation. Transvenous revision of perforated leads is associated with the risk of cardiac tamponade and death. Little is known about periprocedural complications and outcome of these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>All patients referred to our department with evidence or suspicion of cardiac perforation following CIED implantation underwent chest X\u2010ray, transthoracic echocardiography, device interrogation, and, if necessary, a cardiac computed tomography (CT)\u2010scan to diagnose lead perforation and associated complications. Transvenous lead revision (TLR) was performed in all patients with evidence of lead perforation. Patient characteristics, procedural complications, and outcome were recorded and analyzed.<\/jats:p>\n                    <jats:p>\n                      Fifty\u2010six patients (75 \u00b1 10 years, 43% male) were diagnosed with cardiac perforation, 34 patients (61%) early within 30 days post\u2010implantation, and 22 patients (39%) thereafter. The most frequent perforation site was the right ventricular (RV) apex (75%), followed by the RV free wall (16%) and the right atrial appendage (9%). A total of 16 patients (29%) presented with severe complications; 12 patients (21%) with pericardial effusion treated by pericardiocentesis before lead revision and four patients (7%) with hematothorax requiring drainage. Late perforations showed significantly more frequent cardiac tamponades (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.041). TLR was performed without further complications in 54 patients (96%). None of the patients required surgical treatment or experienced in\u2010hospital death.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cardiac perforation following CIED implantation is associated with severe complications in nearly one\u2010third of the cases. Transvenous revision of the perforated lead can safely be performed with a very low complication rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.14056","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T00:13:42Z","timestamp":1600647222000},"page":"1325-1332","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Transvenous revision of leads with cardiac perforation following device implantation\u2014Safety, outcome, and complications"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1372-3438","authenticated-orcid":false,"given":"Michael","family":"D\u00f6ring","sequence":"first","affiliation":[{"name":"Department of Electrophysiology, Heart Center University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"M\u00fcssigbrodt","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micaela","family":"Ebert","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Bode","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Lucas","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Dagres","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Hindricks","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Richter","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht150"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv316"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw128"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht511"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eun363"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-12-0707"},{"key":"e_1_2_9_8_1","first-page":"96","article-title":"Incidence and predictors of clinically relevant cardiac perforation associated with systematic implantation of active\u2010fixation pacing and defibrillation leads: a single\u2010centre experience with over 3800 implanted leads","volume":"19","author":"Cano O","year":"2017","journal-title":"Europace"},{"key":"e_1_2_9_9_1","first-page":"245","article-title":"Complications after surgical procedures in patients with cardiac implantable electronic devices: results of a prospective registry","volume":"107","author":"Silva KR","year":"2016","journal-title":"Arq Bras Cardiol"},{"key":"e_1_2_9_10_1","first-page":"508","article-title":"Cardiac chambers perforation by pacemaker and cardioverter\u2010defibrillator leads. 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