Abstract
<h2> </h2> A simple and reliable radiographic method to aid in the detection of penetration or perforation of the myocardium by permanent transvenous pacemaker electrodes is described. The "epicardial fat-pad sign" was clearly positive in three "symptomatic" patients in whom electrodes had perforated the myocardium and in eight of 28 "nonsymptomatic" patients with pacemakers implanted as long as three years. The incidence, management, and clinical implications of myocardial perforation as a complication of transvenous pacemakers are discussed. It is suggested that patients in whom pacemaker electrodes have perforated be closely observed, and that repositioning of the pacemaker electrode be performed when an adequate cardiac escape mechanism is thought to be lacking.
Published Version
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