{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:02:46Z","timestamp":1791932566778,"version":"4.3.4"},"reference-count":10,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,4,22]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>Myocardial perforation is an uncommon but potentially life-threatening complication of pacemaker and implantable cardioverter-defibrillator. Myocardial perforation may be acute, subacute or chronic when it occurs within 24 hours of the device insertion; between 1 day and 30 days; and more than 30 days after implantation. This complication may occur in 1.7%\u20137% of patients. However, subacute myocardial perforation is rare and affects 0.5%\u20131.2% of patients. We report the case of an 85-year-old patient with a pacemaker failure 10 days after implantation due to a subacute myocardial perforation caused by an active fixation ventricular lead. Transthoracic echocardiography showed penetration of the ventricular lead through the right ventricular apex into the pericardium without any pericardial effusion. We confirmed myocardial perforation by a CT scan. We referred her to the surgery ward where she was successfully managed.<\/jats:p>","DOI":"10.1136\/bcr-2021-242489","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T13:16:29Z","timestamp":1620825389000},"page":"e242489","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Subacute right ventricle perforation: a pacemaker lead complication"],"prefix":"10.1136","volume":"14","author":[{"given":"Emna","family":"Allouche","sequence":"first","affiliation":[{"name":"Cardiology Department, Charles Nicolle Hospital, Tunis, Tunisia"},{"name":"Faculty of Medecine, University of Tunis El Manar, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soumaya","family":"Chargui","sequence":"additional","affiliation":[{"name":"Internal Medicine, Charles Nicolle Hospital, Tunis, Tunisia"},{"name":"Research Laboratory of Renal Pathology LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa","family":"Fathi","sequence":"additional","affiliation":[{"name":"Cardiology Department, Charles Nicolle Hospital, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Bezdah","sequence":"additional","affiliation":[{"name":"Cardiology Department, Charles Nicolle Hospital, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,5,12]]},"reference":[{"key":"2025082711375625000_14.5.e242489.1","article-title":"Incidence and predictors of clinically relevant cardiac perforation associated with systematic implantation of active-fixation pacing and defibrillation leads: a single-centre experience with over 3800 implanted leads","volume":"19","author":"Cano","year":"2017","journal-title":"Europace"},{"key":"2025082711375625000_14.5.e242489.2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eun363"},{"key":"2025082711375625000_14.5.e242489.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2005.06.011"},{"key":"2025082711375625000_14.5.e242489.4","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euw074","article-title":"Diagnosis and management of iatrogenic cardiac perforation caused by pacemaker and defibrillator leads","volume":"61","author":"Rajkumar","year":"2016","journal-title":"Europace"},{"key":"2025082711375625000_14.5.e242489.5","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1007\/s00330-018-5633-6","article-title":"Assessment of cardiac lead perforation: comparison among chest radiography, transthoracic echocardiography and Electrocardiography-gated contrast-enhanced cardiac CT","volume":"29","author":"Zhang","year":"2019","journal-title":"Eur Radiol"},{"key":"2025082711375625000_14.5.e242489.6","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12307"},{"key":"2025082711375625000_14.5.e242489.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2008.07.025"},{"key":"2025082711375625000_14.5.e242489.8","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1111\/pace.12431","article-title":"Clinical, anatomical, and technical risk factors for postoperative pacemaker or defibrillator lead perforation with particular focus on myocardial thickness","volume":"37","author":"Schwerg","year":"2014","journal-title":"Pacing Clin Electrophysiol"},{"key":"2025082711375625000_14.5.e242489.9","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1111\/j.1540-8159.2007.00575.x","article-title":"Prevalence and characterization of asymptomatic pacemaker and ICD lead perforation on CT","volume":"30","author":"Hirschl","year":"2007","journal-title":"Pacing Clin Electrophysiol"},{"key":"2025082711375625000_14.5.e242489.10","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12457"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-242489","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:38:02Z","timestamp":1756319882000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-242489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":10,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,12]]},"published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1136\/bcr-2021-242489"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-242489","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}