Late ventricular pacemaker lead perforation after electrical cardioversion—A case report
Bibliographic record
Abstract
Key Teaching Points•Late lead perforation, >1 month after implant or upgrade, is rare but can present at all times.•Lead perforation should be suspected in case of pleuritic symptoms, a new pericardial effusion, or acute changes in lead measurements upon device interrogation, including unipolar lead measurements.•Lead perforation diagnosis can be confirmed on echocardiogram or computed tomography scan.•Increased awareness for complications shortly after electrical cardioversion is recommended.•The right ventricular lead should be implanted in a septal position, which can be verified in the left anterior oblique view during implant. •Late lead perforation, >1 month after implant or upgrade, is rare but can present at all times.•Lead perforation should be suspected in case of pleuritic symptoms, a new pericardial effusion, or acute changes in lead measurements upon device interrogation, including unipolar lead measurements.•Lead perforation diagnosis can be confirmed on echocardiogram or computed tomography scan.•Increased awareness for complications shortly after electrical cardioversion is recommended.•The right ventricular lead should be implanted in a septal position, which can be verified in the left anterior oblique view during implant.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".