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It was reported that the patient was diagnosed with third-degree atrioventricular (av) block and had an unstable cardiac rhythm, meeting the clinical indications for temporary cardiac pacing.A bedside sterile temporary pacemaker implantation procedure was planned.The cardiologist strictly followed aseptic technique.After removing the pacel bipolar pacing catheter from the package, the original syringe provided in the kit was used to properly withdraw air and slowly inject the standard volume of 1 ml of air into the balloon at the distal tip of the lead.Immediately after inflation, it was observed that the balloon at the distal tip of the pacing lead had ruptured.The incident occurred during the pre-use, extracorporeal balloon inflation test with the pacel in contact with the patient¿s blood path during the balloon rupture.There are no indications as to what caused the balloon to burst.A new pacel bipolar pacing catheter of the same model and batch was used to successfully complete the procedure.The patient remained hemodynamically stable, with no adverse reactions.There was no clinically significant delay in the procedure.
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