Temporary Transvenous Pacemaker Lead-Induced Cardiac Perforation Incidentally Detected by Right Ventriculography Prior to Leadless Pacemaker Implantation

Temporary transvenous pacemakers (TTPs) are lifesaving device in patients with hemodynamically unstable bradycardia, but are associated with serious complications, including right ventricular (RV) perforation. We present a case of a 91-year-old woman with complete atrioventricular block and bradycardia who received a TTP. After that, she underwent leadless pacemaker implantation. Preprocedural right ventriculography (RVG) revealed an incidental RV wall perforation by the TTP lead. After preparing for pericardiocentesis, the lead was safely extracted without complications. This case highlights the utility of RVG in detecting lead-related complications, where it is necessary to prepare pericardiocentesis prior to lead removal.