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October 7, 1974

Perforation of the Tricuspid Valve by a Transvenous Pacemaker

Author Affiliations

From the departments of medicine and pathology (Dr. Yacob), Misericordia-Fordham Affiliation, Bronx, NY, and New York Medical College, New York.

JAMA. 1974;230(1):86-87. doi:10.1001/jama.1974.03240010054032

FOR the past 12 years, permanent and temporary transvenous cardiac pacing has become not only an accepted, but an indispensable and many-pronged tool. It has been used extensively in the treatment of the Adams-Stokes syndrome, and in patients with symptomatic bradyarrhythmia with or without a myocardial infarction. Recently, electrical pacemakers have been employed to override life-threatening arrhythmia refractory to pharmacologic approaches.1

Currently, permanent cardiac pacing is usually accomplished with the insertion of an endocardial electrode through a peripheral vein. Although this approach has simplified pacemaker insertion, various complications can develop. Displacement of the catheter electrode has been reported in all large series and has had an incidence of displacement of 10% to 15%.2,3 Other complications include disruption of the electrode,4 atrial thrombi,5 air embolism,3 endothelization of the catheter,6 phrenic nerve stimulation, and myocardial perforation. This report describes the perforation of a tricuspid value.