Abstract
We present a case of contra-lateral haemopneumothorax and pneumopericardium following a dual chamber ICD implantation using the cephalic vein. The explanation lies in the use of an active fixation atrial (screw-in) lead and not the route of venous access. One should inspect for pneumopericardium when a pneumothorax is present on the CXR and look for right sided pneumothorax even when the cephalic vein was used for access.
Highlights
Ipsilateral pneumothorax and pericardial effusion are recognised complications of cardiac device implantation
We report a case of contra-lateral haemopneumothorax and pneumopericardium following dual chamber Implantable Cardioverter Defibrillator (ICD) insertion using the cephalic vein
A right ventricular screw-in lead (Durata 7120Q, St Jude) placed into the right ventricular apex and a screw-in right atrial lead (Optisense Optim 1999TC, St Jude) was inserted into the right atrial appendage. These leads were connected to an ICD generator (Ellipse DR CD2277-36Q, St Jude) which was placed in the left prepectoral pocket
Summary
Ipsilateral pneumothorax and pericardial effusion are recognised complications of cardiac device (pacemaker/ICD) implantation. Contra-lateral pneumothoraces as well as pneumopericardium are rare complications. We report a case of contra-lateral haemopneumothorax and pneumopericardium following dual chamber Implantable Cardioverter Defibrillator (ICD) insertion using the cephalic vein
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