Perforation of the right ventricular free wall by an ICD lead in a patient with isolated noncompaction of the ventricular myocardium

A 74-year-old patient with isolated noncompaction of the ventricular myocardium (INVM) underwent implantable cardioverter defibrillator (ICD) implantation because of sustained ventricular tachycardia. The post operative course was complicated by perforation of the right ventricular free wall by the ICD lead. The type of the active fixation transvenous ICD lead and the type of background cardiac disease are thought to be major risk factors for perforation.