Tracking an unusually migrated pacing lead

AbstractA rare and fatal complication was encountered during a forensic deliberation. The case focused on a delayed pacing lead migration with multiple organ perforation and a trajectory crossing the right ventricular wall, pericardium, left inferior lung lobe, diaphragm, abdominal cavity to the left retroperitoneum, with the end of the pacing lead stopping close between the left psoas muscle and the left kidney. The above path—identified as the source of fatal bleeding—was found during revision surgery when the lead was removed. The bleeding was made easier by inhibiting platelet function and by a temporary decrease in platelet count as a result of low molecular weight heparin. No symptoms related to the above passage of the lead through the patient´s body were noted