Progressive atrial lead perforation developed 5 years after pacemaker replacement

Summary This report describes an asymptomatic case of atrial lead perforation which developed 5 years after pacemaker implantation. Although retrospective findings of computed tomography showed a screw-in atiral lead had already perforated 9 months after the implantation, the lead protrusion on chest X-rays and pacing failure had not been noticed until another 3 years later. At first, this complication was managed conservatively, however, a lead perforation progressively developed and, as a result, open surgery was performed to remove the lead. We therefore should be aware of the potential occurrence of a progressive protrusion of a perforated lead.