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Case Reports
Published online: 2020-04-27
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Has computed tomography been replaced by three-dimensional echocardiography in the diagnosis of myocardial perforation in patients with implanted electrical devices?

Ludmiła Daniłowicz-Szymanowicz, Michał Świątczak, Elżbieta Krzymińska-Stasiuk, Maciej Kempa, Jadwiga Fijałkowska, Edyta Szurowska, Grzegorz Raczak
DOI: 10.5603/FC.a2020.0016

open access

Ahead of print
Case Reports
Published online: 2020-04-27

Abstract

We present two cases of patients who have had myocardial perforation due to implantation of the cardiac stimulating system. The first is an 81-year-old woman with a history of tachy-brady syndrome, in whom despite the suspicion of perforation in 2D echocardiographic imaging, computed tomography did not confirm the problem, and eventually after a few years clinical symptoms associated with perforation were revealed, which was clearly confirmed in the ECHO 3D study. In the second case, in a 62-year-old man with a pacemaker implanted because of atrioventricular block, 3D echo allowed for an evident diagnosis. The presented cases aim to draw attention to the potential value of 3D echocardiography in the diagnosis of this type of complication.

Abstract

We present two cases of patients who have had myocardial perforation due to implantation of the cardiac stimulating system. The first is an 81-year-old woman with a history of tachy-brady syndrome, in whom despite the suspicion of perforation in 2D echocardiographic imaging, computed tomography did not confirm the problem, and eventually after a few years clinical symptoms associated with perforation were revealed, which was clearly confirmed in the ECHO 3D study. In the second case, in a 62-year-old man with a pacemaker implanted because of atrioventricular block, 3D echo allowed for an evident diagnosis. The presented cases aim to draw attention to the potential value of 3D echocardiography in the diagnosis of this type of complication.
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Keywords

echocardiography, pacemaker, perforation

About this article
Title

Has computed tomography been replaced by three-dimensional echocardiography in the diagnosis of myocardial perforation in patients with implanted electrical devices?

Journal

Folia Cardiologica

Issue

Ahead of print

Published online

2020-04-27

DOI

10.5603/FC.a2020.0016

Keywords

echocardiography
pacemaker
perforation

Authors

Ludmiła Daniłowicz-Szymanowicz
Michał Świątczak
Elżbieta Krzymińska-Stasiuk
Maciej Kempa
Jadwiga Fijałkowska
Edyta Szurowska
Grzegorz Raczak

References (3)
  1. Giunio L, Boric T, Bulat C, et al. Cardiac tamponade after right ventricular perforation caused by screw-in lead. Int J Angiol. 2016; 25(5): e177–e179.
  2. Hirschl DA, Jain VR, Spindola-Franco H, et al. Prevalence and characterization of asymptomatic pacemaker and ICD lead perforation on CT. Pacing Clin Electrophysiol. 2007; 30(1): 28–32.
  3. Migliore F, Zorzi A, Bertaglia E, et al. Incidence, management, and prevention of right ventricular perforation by pacemaker and implantable cardioverter defibrillator leads. Pacing Clin Electrophysiol. 2014; 37(12): 1602–1609.

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