{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:21:37Z","timestamp":1790788897431,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T00:00:00Z","timestamp":1615161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiac implantable electronic device (CIED)\u2010related perforation is uncommon but potentially lethal. Management typically includes the use of computed tomography (CT) scanning and often involves cardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients presenting to a single referral centre with CIED\u2010related cardiac perforation between 2013 and 2019 were identified. Demographics, diagnostic modalities, the method of lead revision, and 30\u2010day complications were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 46 cases were identified; median time from implantation to diagnosis was 14 days (interquartile range\u00a0=\u00a04\u201350). Most were females (29\/46, 63%), 9\/46 (20%) had cancer, 18 patients (39%) used oral anticoagulants, and no patients had prior cardiac surgery. Active fixation was involved in 98% of cases; 9% involved an implantable cardioverter defibrillator lead. Thirty\u2010seven leads perforated the right ventricle (apex: 24) and 9 punctured the right atrium (lateral wall: 5). Abnormal electrical parameters were noted in 95% of interrogated cases. Perforation was visualized in 41% and 6% of cases with chest X\u2010ray (CXR) and transthoracic echocardiography, respectively. CXR revealed a perforation, gross lead displacement, or left\u2010sided pleural effusion in 74% of cases. Pericardial effusion occurred in 26 patients (57%) of whom 11 (24%) developed tamponade, successfully drained percutaneously. Pre\u2010extraction CT scan was performed in 19 patients but was essential in four cases. Transvenous lead revision (TLR) was successfully performed in all cases with original leads repositioned in six patients, without recourse to surgery. Thirty\u2010day mortality and complications were low (0% and 26%, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CT scanning provides incremental diagnostic value in a minority of CIED\u2010related perforations. TLR is a safe and effective strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.14204","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T01:15:40Z","timestamp":1614129340000},"page":"614-624","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Percutaneous management of lead\u2010related cardiac perforation with limited use of computed tomography and cardiac surgery"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2709-1806","authenticated-orcid":false,"given":"Ahmed I.","family":"Elbatran","sequence":"first","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust St. George's University of London  Cranmer Terrace London SW17 0RE UK"},{"name":"Department of Cardiology Ain Shams University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9365-8826","authenticated-orcid":false,"given":"Zaki","family":"Akhtar","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust St. George's University of London  Cranmer Terrace London SW17 0RE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhay","family":"Bajpai","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust St. George's University of London  Cranmer Terrace London SW17 0RE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa W. M.","family":"Leung","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust St. George's University of London  Cranmer Terrace London SW17 0RE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Li","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust St. George's University of London  Cranmer Terrace London SW17 0RE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4767-2918","authenticated-orcid":false,"given":"Simon","family":"Pearse","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust St. George's University of London  Cranmer Terrace London SW17 0RE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zia","family":"Zuberi","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust St. George's University of London  Cranmer Terrace London SW17 0RE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riyaz","family":"Kaba","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust St. George's University of London  Cranmer Terrace London SW17 0RE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdi M.","family":"Saba","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust St. George's University of London  Cranmer Terrace London SW17 0RE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Norman","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust St. George's University of London  Cranmer Terrace London SW17 0RE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Grimster","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust St. George's University of London  Cranmer Terrace London SW17 0RE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6333-6420","authenticated-orcid":false,"given":"Mark M.","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust St. George's University of London  Cranmer Terrace London SW17 0RE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5771-5504","authenticated-orcid":false,"given":"Manav","family":"Sohal","sequence":"additional","affiliation":[{"name":"Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust St. George's University of London  Cranmer Terrace London SW17 0RE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2005.40003.x"},{"key":"e_1_2_10_3_1","first-page":"1031","article-title":"Diagnosis and management of iatrogenic cardiac perforation caused by pacemaker and defibrillator leads","volume":"19","author":"Rajkumar CA","year":"2017","journal-title":"Europace"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2009.05.020"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12472"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12431"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.23327"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw162"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.09.001"},{"key":"e_1_2_10_10_1","first-page":"1","article-title":"Oesophageal perforation: an unexpected complication during extraction of a pacing lead. 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