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Placement of a permanent pacemaker can be complicated by cardiac perforation. Researchers studied 4280 patients who had pacemakers implanted at Mayo Clinic from 1995 through 2003, of whom 50 (1.2%) developed a significant post-implantation pericardial effusion consistent with perforation. Patients who had recently undergone cardiac surgery or had known pericardial effusion before implantation were not counted among the 50.
The 50 subjects were compared with 100 randomly matched pacemaker recipients who had no evidence of postimplantation perforation. In a univariate analysis, significant predictors of suspected perforation were use of a temporary transvenous pacemaker, oral steroid use during the 7 days before implantation, use of active-fix…