Cardiac perforation is a rare but serious complication that can occur during the implantation of transvenous pacemakers, most commonly at the apex of the heart.
A case was reported where a patient's ventricular lead perforated the ventricular septum six days post-pacemaker implantation, resulting in the lead exiting the left ventricle and causing the need for cardiac surgery.
This case highlights that even with proper lead placement in the right ventricle, perforation can still happen, illustrating the risks associated with pacemaker procedures.