What indicates a sign of septal perforation?

A negative current of injury along with an impedance drop is indicative of septal perforation. In the context of cardiac pacing and lead placement, septal perforation can occur when an electrode penetrates the septal wall, potentially leading to complications such as bleeding or cardiac tamponade.

When septal perforation occurs, the pacing lead may disrupt normal electrical conduction and pacing, resulting in a negative current of injury. This is characterized by a shift in the electrical parameters as the lead loses good contact with the myocardium, which translates into a drop in the measured impedance. Impedance is a measure of resistance to the electrical flow, and a significant drop in impedance suggests a loss of proper contact, often due to the lead moving away from the tissue or penetrating through it entirely. This change is critical for identifying the complication in real-time to ensure timely intervention and management.

In contrast, a stable impedance level suggests that the lead is appropriately seated within the tissue, while normal current readings indicate that there are no electrical disturbances associated with lead placement. A positive current of injury might suggest ischemia or damage but is not specifically indicative of septal perforation. Understanding these parameters is vital for clinicians to diagnose potential complications following lead placement effectively.