Why the study?
Inadvertent lead malposition of a temporary pacing wire is a rare complication of pacemaker insertion that requires discussion regarding its occurrence, recognition, and management.
A right bundle branch block pattern on ECG following temporary pacing should raise suspicion for inadvertent left ventricular lead placement, which requires prompt imaging and repositioning to avoid thromboembolic complications.
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ECG vigilance may flag ILM in temporary pacing; leaves open incidence and prevention questions.
Inadvertent lead malposition (ILM) of a temporary pacing wire is a rare complication that can occur during pacemaker insertion. We report a case of a 40-year-old man who presented late following an inferior ST segment elevation myocardial infarction. Temporary cardiac pacing was performed for symptomatic complete heart block. A 12-lead electrocardiogram (ECG) on the following day showed a paced QRS complex with right bundle branch block pattern. Malposition of the pacing wire was suspected to be in the left ventricle and confirmed by chest X-rays and an echocardiogram. This article discusses the occurrence of inadvertent left ventricle pacing and its management. Early recognition with the help of echocardiogram and ECG will aid in reducing the incidence of such complications.
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Shanker et al. (2024) studied this question.
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