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Journal of Medical Case Reports

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Open Access 01-12-2011 | Case report

Inadvertent malposition of a permanent pacemaker ventricular lead into the left ventricle which was initially missed and diagnosed two years later: a case report

Authors: Medhat F Zaher, Basem N Azab, Marc B Bogin, Soad G Bekheit

Published in: Journal of Medical Case Reports | Issue 1/2011

Abstract

Introduction

Inadvertent malposition of a pacemaker ventricular lead into the left ventricle is an uncommon event, and its actual incidence is probably unknown. It may be underestimated and underreported because of a possible asymptomatic course. A 12-lead electrocardiogram is important to confirm proper placement.

Case presentation

We report a case of a 60-year-old Caucasian man with a malpositioned transvenous permanent pacing lead into the left ventricle via a patent foramen ovale that was not suspected during implantation and went undiagnosed for two years without complications. The patient remained asymptomatic as he was being treated with oral anticoagulation therapy for atrial fibrillation. The decision was made to leave the pacing lead in place and continue lifelong warfarin therapy.

Conclusions

Inadvertent insertion of pacing wires into the left ventricle is a potentially dangerous complication that may happen under fluoroscopic guidance and may be overlooked by routine pacemaker interrogation. It is advisable to obtain a 12-lead electrocardiogram during or immediately after transvenous pacemaker implantation rather than use a routine pacemaker interrogation or a limited electrocardiogram.

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Title: Inadvertent malposition of a permanent pacemaker ventricular lead into the left ventricle which was initially missed and diagnosed two years later: a case report
Authors: Medhat F Zaher
Basem N Azab
Marc B Bogin
Soad G Bekheit
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2011
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/1752-1947-5-54

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Inadvertent malposition of a permanent pacemaker ventricular lead into the left ventricle which was initially missed and diagnosed two years later: a case report

Abstract

Introduction

Case presentation

Conclusions

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Abstract

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Case presentation

Conclusions

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