Diagnosis and management of inadvertently placed pacemaker lead in the left ventricle following sinus venosus atrial septal defect repair surgery

Figures

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  Figure 1. A: Twelve-lead electrocardiogram (ECG) showing ventricular paced rhythm with right bundle branch block pattern and frequent premature ventricular complexes. B: Twelve-lead ECG post left ventricular lead extraction and lead placement in right ventricle.

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  Figure 2. Chest radiographs, A: posteroanterior and B: lateral, showing a single-chamber pacemaker lead with ventricular lead in a leftward position within the left ventricle (LV). C: Sagittal computed tomography (CT) scan of the chest showing pacemaker lead (arrow) passing through the superior vena cava (SVC) and into the left atrium (LA). D: Coronal section of chest CT scan showing pacemaker lead (arrow) going through the SVC and passing through the LA into the LV (asterisks).

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  Figure 3. A: Transthoracic echocardiography parasternal long-axis view showing pacemaker lead (arrow) crossing the mitral valve from the left atrium (LA) into the left ventricle (LV). B, C: Transesophageal echocardiography (TEE) bicaval view showing pacemaker lead (arrow) going from superior vena cava (SVC) / right atrium (RA) junction into LA around patch repair (asterisks). D: TEE 4-chamber view showing pacemaker lead (arrow) in the LA and LV. RSPV = right superior pulmonary vein; RV = right ventricle.