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Ultra-Chronic ICD Lead Perforation: A Case of an FDG-Avid Pericardial Effusion

Year: 2025

Type: article

Abstract: Chronic implantable cardioverter-defibrillator (ICD) lead perforation is a rare but serious complication, often diagnosed via computed tomography. A 51-year-old man with cardiac sarcoidosis and a dual-chamber ICD presented with progressive chest pain. A routine 18F-fluoro-2-deoxy-2-D-glucose (FDG) positron emission tomography/computed tomography scan revealed an FDG–avid cystic lesion, later confirmed as an inflammatory pericardial effusion with gross ICD lead perforation. Echocardiography showed right ventricular compression. He had percutaneous lead extraction using a laser sheath, with symptom resolution. This case, with a 17-year dwell time, represents the longest documented chronic perforation successfully treated percutaneously, highlighting an unusual presentation in a patient with cardiac sarcoidosis.

Source: Annals of Internal Medicine Clinical Cases

DOI: 10.7326/aimcc.2025.0147

Authors: Michael Litt, Paco Bravo, Adrian Petzl, Carly Kindbom, Gregory Supple, Benjamin D'Souza, Ana Kolansky, Victor A. Ferrari, Mauer Biscotti, Robert D. Schaller

Institutions: Hospital of the University of Pennsylvania, University of Pennsylvania, Penn Presbyterian Medical Center

Language: English

Topic: Cardiac pacing and defibrillation studies

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4413921728

FWCI:

Cites: 5

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Related to: 10