Abstract
A 78-year-old male patient was brought via the Primary
percutaneous coronary intervention (PPCI) service to our hospital for
urgent angiography. He had been discharged a week ago, after presenting
with chest pain and undergoing Primary Percutaneous intervention (PCI)
to the Left Circumflex artery, followed by Permanent pacemaker insertion
for treatment of Sick Sinus Syndrome. CT Coronary
angiography/CT Chest demonstrated a right ventricular lead perforation,
alongside an occlusion in the mid-distal segment of the recently
inserted stent in the circumflex artery. The diagnosis
required careful interpretation of the pacing check, and a high clinical
suspicion of lead perforation. The perforated lead was removed, and a
new lead positioned in the Right ventricular septum the following day.
There was also an attempt to open the occluded circumflex artery, but
this was unsuccessful.
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