Cor Vasa 2022, 64(5):554-556 | DOI: 10.33678/cor.2021.111
Cough, a rare and not well recognized symptom of lead perforation
- Cardiology Unit, Department of Clinical and Experimental Medicine, University Hospital of Messina, Italy
A 64-year-old woman was admitted to our department for dual-chamber pacemaker implantation. No complication apparently occurred during the procedure. An active fixation ventricular lead was positioned in right ventricular septal apex. Soon after implantation the patient started to suffer from non-productive cough, clearly related to ventricular stimulation. Transthoracic echocardiography revealed a small pericardial effusion along the apical segments. The patient underwent urgent contrast chest CT confirming pericardial effusion, and showing an intramyocardium placement of the right ventricular apical lead. Due to persistence of symptoms, we decided to perform right ventricular lead repositioning in right middle septum. Post-procedure, cough abruptly disappeared.
Keywords: Cough, Lead perforation, Pacemaker implantation, Tamponade
Received: September 2, 2021; Revised: September 2, 2021; Accepted: September 18, 2021; Published: November 1, 2022 Show citation
References
- Clémenty N, Fernandes J, Carion PL, et al. Pacemaker complications and costs: a nationwide economic study. J Med Econ 2019;22:1171-1178.
Go to original source... 
Go to PubMed... - Udo EO, Zuithoff NP, van Hemel NM, et al. Incidence and predictors of short- and long-term complications in pacemaker therapy: the FOLLOWPACE study. Heart Rhythm 2012;9:728-735. Go to original source... Go to PubMed...
- Schüller H, Brandt J. The pacemaker syndrome: old and new causes. Clin Cardiol 1991;14:336-340. Go to original source... Go to PubMed...
- Naito M, Dreifus LS, David D, et al. Reevaluation of the role of atrial systole to cardiac hemodynamics: evidence for pulmonary venous regurgitation during abnormal atrioventricular sequencing. Am Heart J 1983;105:295-302. Go to original source... Go to PubMed...
- 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;30:28-32. Go to original source... Go to PubMed...
- Ahmed A, Shokr M, Lieberman R. Subacute Right Ventricular Perforation by Pacemaker Lead Causing Left-Sided Hemothorax and Epicardial Hematoma. Case Rep Cardiol 2017;2017:1264734. Go to original source... Go to PubMed...
- Mahapatra S, Bybee KA, Bunch TJ, et al. Incidence and predictors of cardiac perforation after permanent pacemaker placement. Heart Rhythm 2005;2:907-911. Go to original source... Go to PubMed...
- Steiner S, Schueller PO, Blondin D, Winter J. Cough as a rare symptom of a pacemaker lead perforation. Pneumologie 2015;69:86-88. Go to original source... Go to PubMed...
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.