It was reported that during implant of the left ventricular (lv) lead, there was a failure in slitting the guide catheter after lead placement.The lv lead was confirmed to have been dislodged from a considerably pulled position under fluoroscopy.Afterwards, an attempt was made to place the lv lead again, but a patient abnormality was noticed after guide catheter cannulation.As blood pressure did not touch and the patient was not conscious, an echocardiogram was performed and confirmed a cardiac tamponade had occurred due to lv lead perforation.A pericardial puncture and cardiac massage were performed.Then, percutaneous cardiopulmonary support and an intra-aortic balloon pump (iabp) were inserted, and a thoracotomy was performed.Hemostasis was successfully achieved.Post evaluation of the patient revealed that the coronary sinus region that was fixated with the lv lead screw, was reported to have ruptured.The lv lead was not implanted.No further patient complications have been reported as a result of this event.
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