{"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":1790788897362,"version":"4.1.0"},"reference-count":16,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T00:00:00Z","timestamp":1707350400000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,1,24]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:p>A woman in her 80s experienced a life-threatening complication of pacemaker implant consisting of subacute right ventricular lead perforation causing iatrogenic injury to an intercostal artery, resulting in a large haemothorax. A CT scan confirmed active bleeding from the fourth intercostal artery. The patient underwent cardiothoracic surgery via a median sternotomy approach, during which the source of the bleeding was sealed, a new epicardial lead was positioned, and the original lead was extracted. This case emphasises the potentially severe consequences of pacemaker lead perforation and secondary injury to adjacent structures. It underscores the importance of early recognition and timely intervention, preferably in a tertiary specialist unit equipped for cardiothoracic surgery and confirms the value of pacemaker interrogation and CT scans for diagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2023-258314","type":"journal-article","created":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T01:35:23Z","timestamp":1707356123000},"page":"e258314","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Right ventricular lead perforation with iatrogenic injury to an intercostal artery causing haemothorax after pacemaker implant"],"prefix":"10.1136","volume":"17","author":[{"given":"Anna","family":"Bj\u00f6rkenheim","sequence":"first","affiliation":[{"name":"Department of Cardiology, School of Medical Sciences Campus US\u00d6, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torbj\u00f6rn","family":"Kalm","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u00d6rebro University Hospital, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Lid\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Physics, Faculty of Medicine and Health, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e5rten","family":"Vidlund","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, \u00d6rebro University Hospital, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,2,7]]},"reference":[{"key":"2025082723210600000_17.2.e258314.1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab364"},{"issue":"suppl_2","key":"2025082723210600000_17.2.e258314.2","doi-asserted-by":"crossref","first-page":"ii1","DOI":"10.1093\/europace\/eux258","article-title":"A Decade of Information on the Use of Cardiac Implantable Electronic Devices and Interventional Electrophysiological Procedures in the European Society of Cardiology Countries: 2017 Report from the European Heart Rhythm Association","volume":"19","author":"Raatikainen","year":"2017","journal-title":"Europace"},{"key":"2025082723210600000_17.2.e258314.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2011.03150.x"},{"key":"2025082723210600000_17.2.e258314.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(03)00844-0"},{"key":"2025082723210600000_17.2.e258314.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.113.000299"},{"key":"2025082723210600000_17.2.e258314.6","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.hrcr.2021.11.012","article-title":"An unusual presentation of delayed lead perforation: It\u2019s never too late","volume":"8","author":"Jain","year":"2022","journal-title":"HeartRhythm Case Rep"},{"key":"2025082723210600000_17.2.e258314.7","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1093\/europace\/euz120","article-title":"The management of cardiac implantable electronic device lead perforations: a multicentre study","volume":"21","author":"Rav Acha","year":"2019","journal-title":"Europace"},{"key":"2025082723210600000_17.2.e258314.8","doi-asserted-by":"crossref","DOI":"10.1186\/s40981-021-00470-8","article-title":"Right ventricular perforation, pneumothorax, and a pneumatocele by a pacemaker lead: a case report","volume":"7","author":"Iwata","year":"2021","journal-title":"JA Clin Rep"},{"key":"2025082723210600000_17.2.e258314.9","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw054"},{"key":"2025082723210600000_17.2.e258314.10","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.ijcard.2007.04.189","article-title":"Fluoroscopy to assess late heart and lung perforation by A permanent ventricular pacemaker lead. 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