Key result
Three-dimensional transesophageal echocardiography was beneficial in evaluating an incidental finding of pacemaker lead malposition in the left ventricle prior to lead extraction.
Why the study?
Inadvertent endocardial lead malposition into the left ventricle is a rare and underreported incident that can be easily corrected if recognised during implantation.
Case Report (n=1)
Three-dimensional transesophageal echocardiography is beneficial for evaluating inadvertently malpositioned pacemaker leads in the left ventricle prior to extraction.
Clinicians should vigilantly check for rare LV lead malposition during implantation; case report leaves open true incidence and optimal screening.
Inadvertent endocardial lead malposition is recognised as a rare incident which is usually underreported and if recognised during implantation can be easily corrected. This phenomenon is caused by the ventricular lead unintentionally crossing a pre-existing patent foremen ovale, septal defects (atrial or ventricular) or directly from the aorta via an accidental subclavian puncture resulting in the lead implanting into the left ventricle. While this is a rare occurrence we report the incidental finding of pacemaker lead malposition during a routine follow-up transthoracic echocardiogram and the benefits of three dimensional transoesophageal echocardiography in this patient prior to lead extraction.
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Luke et al. (2020) conducted a case report in Permanent pacemaker lead malposition in the left ventricle (n=1). Three dimensional transoesophageal echocardiography was evaluated. Three-dimensional transesophageal echocardiography was beneficial in evaluating an incidental finding of pacemaker lead malposition in the left ventricle prior to lead extraction.
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