{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:48:52Z","timestamp":1765889332422,"version":"3.37.3"},"reference-count":5,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T00:00:00Z","timestamp":1716508800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T00:00:00Z","timestamp":1716508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Egypt Heart J"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Perforation by pacemaker leads, although rare, is a complication reported since the introduction of pacemaker therapy. Although historically reported frequencies were as high as 5%, recent reports have cited frequencies ranging from 1 to 2%. We report a case where a screw-type atrial lead slightly penetrated the right atrial wall, causing chronic abrasion of the ascending aorta, resulting in shock.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 54-year-old male presented with dilated cardiomyopathy diagnosed at 40\u00a0years of age when he developed decompensated heart failure. Despite ongoing treatment, his heart failure worsened, leading to hospitalization at the age of 54. During his hospital stay, he experienced cardiac arrest that required cardiopulmonary resuscitation, followed by a return of spontaneous circulation. He was subsequently transferred to our institution after initiation of venoarterial extracorporeal membrane oxygenation (VA-ECMO) and an intra-aortic balloon pump (IABP). Echocardiography revealed an ejection fraction of 25%, left ventricular end-diastolic diameter of 60\u00a0mm, and severe mitral regurgitation (MR). Transcatheter mitral valve repair was performed to treat severe MR, followed by implantation of a cardiac resynchronization therapy defibrillator (CRT-D). Three\u00a0months later, the patient was brought to our emergency department by ambulance because of hypotension. Contrast-enhanced computed tomography revealed pericardial effusion causing cardiac tamponade, necessitating emergency pericardial decompression via left fourth intercostal mini-thoracotomy and drain placement. Upon transfer to the intensive care unit, 1200\u00a0mL of blood was drained from the chest tube, prompting a return to the operating room for a median sternotomy. It was discovered that the pacemaker lead on the left side of the right atrium had slowly eroded into the aorta, leading to perforation. The ascending aorta was repaired and hemostasis was achieved; the patient recovered uneventfully and was discharged on postoperative day 18.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The pacemaker lead perforated the right atrium; chronic abrasion of the lead against the ascending aorta resulted in bleeding from the ascending aorta 3\u00a0months later.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s43044-024-00494-2","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T20:20:54Z","timestamp":1716582054000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A screw-type pacemaker lead implanted in the right atrium perforated the ascending aorta"],"prefix":"10.1186","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8727-4212","authenticated-orcid":false,"given":"Tomohiro","family":"Nakajima","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Iba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuyoshi","family":"Shibata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayumu","family":"Osamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoyuki","family":"Kamiyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Nishikawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junji","family":"Nakazawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuyoshi","family":"Kawaharada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,24]]},"reference":[{"issue":"3","key":"494_CR1","doi-asserted-by":"publisher","first-page":"327","DOI":"10.14503\/THIJ-13-3219","volume":"41","author":"A Di Marco","year":"2014","unstructured":"Di Marco A, Nu\u00f1ez E, Osorio K, Dallaglio P, Anguera I, Toscano J, Sabat\u00e9 X, Cequier A (2014) Aortic perforation by active-fixation atrial pacing lead: an unusual but serious complication. Tex Heart Inst J 41(3):327\u2013328. https:\/\/doi.org\/10.14503\/THIJ-13-3219","journal-title":"Tex Heart Inst J"},{"key":"494_CR2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.1865","author":"A Saradna","year":"2017","unstructured":"Saradna A, Sinha A, Abduraimova M, Rodriguez D, Yang F (2017) Tale of a wandering lead: late atrial lead perforation into right lung following pacemaker implantation. Cureus. https:\/\/doi.org\/10.7759\/cureus.1865","journal-title":"Cureus"},{"issue":"2","key":"494_CR3","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.hrcr.2020.11.012","volume":"7","author":"C Grebmer","year":"2021","unstructured":"Grebmer C, Russi I, Kobza R, Berte B (2021) Atrial lead perforation early after device implantation: a case series. Heart Rhythm Case Rep 7(2):100\u2013105. https:\/\/doi.org\/10.1016\/j.hrcr.2020.11.012","journal-title":"Heart Rhythm Case Rep"},{"issue":"2","key":"494_CR4","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1016\/j.jtcvs.2007.03.037","volume":"134","author":"ML Kaljusto","year":"2007","unstructured":"Kaljusto ML, T\u00f8nnessen T (2007) Aortic perforation with cardiac tamponade two weeks after pacemaker implantation. J Thoracic Cardiovasc Surg 134(2):502\u2013503. https:\/\/doi.org\/10.1016\/j.jtcvs.2007.03.037","journal-title":"J Thoracic Cardiovasc Surg"},{"issue":"1","key":"494_CR5","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.jjcc.2008.07.006","volume":"53","author":"K Sadamatsu","year":"2009","unstructured":"Sadamatsu K, Enomoto N, Tsuji M, Tashiro H (2009) Progressive atrial lead perforation developed 5 years after pacemaker replacement. J Cardiol 53(1):150\u2013153. https:\/\/doi.org\/10.1016\/j.jjcc.2008.07.006","journal-title":"J Cardiol"}],"container-title":["The Egyptian Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-024-00494-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s43044-024-00494-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-024-00494-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T20:30:53Z","timestamp":1716582653000},"score":1,"resource":{"primary":{"URL":"https:\/\/tehj.springeropen.com\/articles\/10.1186\/s43044-024-00494-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,24]]},"references-count":5,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["494"],"URL":"https:\/\/doi.org\/10.1186\/s43044-024-00494-2","relation":{},"ISSN":["2090-911X"],"issn-type":[{"type":"electronic","value":"2090-911X"}],"subject":[],"published":{"date-parts":[[2024,5,24]]},"assertion":[{"value":"23 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"A written informed consent of all details\/images relating to the patient for publication was obtained from the patient.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"63"}}