A lead extraction procedure reportedly commenced to extract two leads: a right ventricular (rv) and a right atrial (ra) lead due to infection.A spectranetics glidelight device and lead locking devices were in use, among other mechanical and laser sheaths with frequent switching of devices due to the complexity of the case.While removing the rv lead, it was impossible to reach the end of the lead with the extraction catheter due to the acute angulation of the tip where it was implanted in the apex of the heart.Reportedly, when pulling against the heart apex with use of the lld within the lead, the apex gave way.A small laceration in the myocardium led to the development of an acute tamponade, recognized by bedside echocardiography.Rescue efforts commenced immediately and a drain was placed.The patient survived the procedure and was subsequently discharged.
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