North Texas Research Forum 2024



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North Texas


Medical City Arlington


Internal Medicine

Document Type


Publication Date



pacemaker, right ventricular perforation, non-ischemic cardiomyopathy, defibrillator, surgical complications


Cardiovascular Diseases | Internal Medicine | Medicine and Health Sciences


Pacemaker-lead associated complications are often documented in elderly populations with ischemic heart disease. Acute perforations within 24 hours of implantation are the most common, and immediate life-threatening complications are most likely to occur during an acute perforation. Subacute perforations between 1 day and 30 days after implantation are less common and carry a lower risk of life-threatening complications. Here, we present a unique case of subacute right ventricular perforation in a young individual with non-ischemic cardiomyopathy, challenging the conventional understanding of such an occurrence. Further adding to the intrigue of our case, the patient had recurrent hospital visits both before and after the perforation, allowing us to pinpoint the time of perforation a small window of 4 days, between postoperative day 16 and postoperative day 20. It also indicates a possibility that the near syncope, vertigo, and nausea experienced by the patient might be initial signs of impending perforation. This case highlights the importance of early recognition of possible pacemaker-lead perforation symptoms so that appropriate investigation and management may prevent further complications. While the younger age of the patient in this case might have a prognostic advantage, the possibility of right ventricular perforation in the setting of non-ischemic dilated cardiomyopathy requires further investigation to establish true association and risk.

Original Publisher

HCA Healthcare Graduate Medical Education

Subacute Defibrillator Lead Associated Right Ventricular Perforation in a Young Individual with Non-Ischemic Cardiomyopathy: A Unique Clinical Case



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