Late atrial appendage perforation from a pacemaker lead pacemaker complication.

Lead perforation is a rare complication of device implantation, varying between 0.3% and 1%, although the prevalence may be higher. Late lead perforations (>1 month after implantation) are believed to be very rare. We describe the successful treatment of a 65-year-old man with late cardiac perforation due to the pacemaker active fixation lead after an uneventful implantation.