Abstract

Permanent pacemaker implantation is life saving but sometimes the procedure may itself become life threatening. Right ventricular perforation is a rare complication during pacemaker insertion that could be life-threatening and need immediate intervention. Chest X-ray, echocardiogram and computer tomogram of chest are used to diagnose lead migration and its complications. We present a rarest of the rare case in which a seventy six year old patient undergoing permanent pacemaker implantation suffered both iatrogenic cardiac injury leading to hemopericardium and pacemaker malfunction as well as injury to left pleura leading to massive pneumothorax and hemodynamic instability which was managed successfully.