An elective coronary artery bypass grafting (CABG) surgery was performed on a 50-year-old male with an implanted two-chamber pacemaker in our clinic. Right ventricular adhesion to the inferior pericardium was detected following pericardiotomy. After the institution of cardiopulmonary bypass (CPB), careful preparation of the adhesion revealed prior perforation due to an indwelling ventricular pacemaker lead.