Two-dimensional echocardiography is useful for diagnosing pacing lead malplacement in patients who develop a right bundle branch block pattern post-implantation.
Echocardiography may confirm suspected lead malposition in isolated cases; leaves open its routine diagnostic role pending larger studies.
This report describes a patient in whom a permanent transvenous pacemaker lead was placed unintentionally across the atrial septum and retained in the left ventricle for nearly 11 years before the error was recognized. A 12‐lead electrocardiogram showed paced complexes with right bundle branch block configuration. This appearance raised suspicion that the pacemaker electrode might be in the left ventricle and this was confirmed by two‐dimensional echocardiography. Two‐dimensional echocardiography is useful for the diagnosis of pacing lead malplacement and should be performed in any patient who develops right bundle branch block pattern on the surface electrocardiogram following pacemaker implantation.
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LOUNGANI et al. (1993) studied this question.
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