open access

Vol 11, No 6 (2016)
Case report
Published online: 2016-09-15
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The random placement of pacing lead in the left ventricle in a patient with patent foramen ovale

Agnieszka Łętek, Jacek Kurzawski, Marcin Sadowski
DOI: 10.5603/FC.a2016.0092
·
Folia Cardiologica 2016;11(6):535-538.

open access

Vol 11, No 6 (2016)
Case Reports
Published online: 2016-09-15

Abstract

The random placement of pacing lead in the left ventricle (LV) is a rare and late diagnosed complication of the permanent heart stimulation. In most cases the intracardiac electrode moves through the interatrial septum or through the patent foramen ovale to the LV. On ECG the sets of QRS have morphology of right bundle branch block. The decisive survey used to identify this complication is echocardiography, especially transesophageal study. The malposition of the pacing electrode is associated with the risk of thromboembolic complications. The treatment consists of early lead removal. In case of lack of such a possibility the chronic anticoagulation treatment has to be started. The paper presents a case of incorrect position of pacing electrode in LV in a patient with PFO.

Abstract

The random placement of pacing lead in the left ventricle (LV) is a rare and late diagnosed complication of the permanent heart stimulation. In most cases the intracardiac electrode moves through the interatrial septum or through the patent foramen ovale to the LV. On ECG the sets of QRS have morphology of right bundle branch block. The decisive survey used to identify this complication is echocardiography, especially transesophageal study. The malposition of the pacing electrode is associated with the risk of thromboembolic complications. The treatment consists of early lead removal. In case of lack of such a possibility the chronic anticoagulation treatment has to be started. The paper presents a case of incorrect position of pacing electrode in LV in a patient with PFO.

Get Citation

Keywords

cardiac pacing, inadvertent left ventricular pacing, lead removal, anticoagulation therapy

About this article
Title

The random placement of pacing lead in the left ventricle in a patient with patent foramen ovale

Journal

Folia Cardiologica

Issue

Vol 11, No 6 (2016)

Article type

Case report

Pages

535-538

Published online

2016-09-15

DOI

10.5603/FC.a2016.0092

Bibliographic record

Folia Cardiologica 2016;11(6):535-538.

Keywords

cardiac pacing
inadvertent left ventricular pacing
lead removal
anticoagulation therapy

Authors

Agnieszka Łętek
Jacek Kurzawski
Marcin Sadowski

References (8)
  1. Maziarz A, Ząbek A, Małecka B, et al. An inadvertent placement of pacing lead in the left ventricle — an analysis of three cases. Pol Przegl Kardiol. 2010; 12: 164–168.
  2. Shmuely H, Erdman S, Strasberg B, et al. Seven years of left ventricular pacing due to malposition of pacing electrode. Pacing Clin Electrophysiol. 1992; 15(4 Pt 1): 369–372.
  3. Ghani M, Thakur RK, Boughner D, et al. Malposition of transvenous pacing lead in the left ventricle. Pacing Clin Electrophysiol. 1993; 16(9): 1800–1807.
  4. Yang YN, Yin WH, Young MS. Safe right bundle branch block pattern during permanent right ventricular pacing. J Electrocardiol. 2003; 36(1): 67–71.
  5. Zielińska M, Kaczmarek K, Koniarek W, et al. [The significance of electrocardiogram in the estimation of correct lead position in patients with permanent ventricular pacing]. Wiad Lek. 2006; 59(7-8): 580–584.
  6. Okmen E, Erdinler I, Oguz E, et al. An electrocardiographic algorithm for determining the location of pacemaker electrode in patients with right bundle branch block configuration during permanent ventricular pacing. Angiology. 2006; 57(5): 623–630.
  7. Moszczyńska-Stulin J, Kübler G, Goździk A, et al. An accidental localisation of transvenous pacemaker lead in the left ventricle — an uncommon or rare-diagnosed complication? Folia Cardiol. 2003; 10: 231–236.
  8. Van Gelder BM, Bracke FA, Oto A, et al. Diagnosis and management of inadvertently placed pacing and ICD leads in the left ventricle: a multicenter experience and review of the literature. Pacing Clin Electrophysiol. 2000; 23(5): 877–883.

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