ABSTRACT
Infection of pacemaker electrode is one of the most frequent causes for the removal of the permanent cardiac pacemaker electrode and it is dangerous to remove the infected electrode by external traction method because the electrode is adhered to the myocardium. In this case, surgeon tried to remove infected cardiac pacing electrode using continuous external traction method. Myocardial rupture and consequent cardiac tamponade suddenly developed because the electrode was pulled by force. Emergent cardiopulmonary bypass was initiated and then, ruptured myocardium was repaired and the remaining electrode was removed without remarkable complications. This case emphasizes the risk of the myocardial rupture and the importance of preparing for emergent situation which can occur during the removal of the permanent pacemaker electrode, especially when the reason for the removal is the infection.