Key result
In a 71-year-old man with an asymptomatic inadvertent pacemaker lead malposition in the left ventricle discovered 23 months post-implantation, conservative management with lifelong oral anticoagulation was chosen over lead extraction.
Why the study?
Inadvertent lead malposition in the left ventricle is a rare and underdiagnosed incident during cardiac electronic device implantation that may remain asymptomatic.
Case Report (n=1)
No
Inadvertent left ventricular lead malposition can be diagnosed incidentally by echocardiography and managed conservatively with anticoagulation in older patients with delayed presentation.
Answers are grounded in this paper and cite their sources.
Echocardiography may detect asymptomatic LV lead malposition post-implantation; leaves open the value of routine screening in pacemaker recipients.
Inadvertent Lead Malposition in Left Ventricle is a rare and underdiagnosed incident, which may occur during implantation of cardiac electronic devices and may remain asymptomatic. We reported the case of a 71-year-old man who was implanted with a ventricular single-chamber pacemaker for a slow atrial fibrillation with syncope and whose routine transthoracic echocardiography 23 months after implantation displayed a malposition of the pacemaker lead into the Left Ventricle through a patent foramen oval. The patient was asymptomatic. The electrocardiogram showed right bundle branch block QRS-paced morphology with a positive QRS pattern in V1, a median paced QRS axis on the frontal plane at -120°, a Precordial transition on V5. At the lateral Chest X-ray the lead curved backwards to the spine. Given the age of this old patient who already received oral anticoagulant for Atrial Fibrillation and the Lead malposition discovered 23 months after pacemaker’s implantation, we decided to maintain the lead in LV and continue anticoagulation.
No takes yet. Share an insight, caveat, or question.
Dia et al. (2023) conducted a case report in Inadvertent Lead Malposition in the Left Ventricle (n=1). Conservative management with oral anticoagulation was evaluated. In a 71-year-old man with an asymptomatic inadvertent pacemaker lead malposition in the left ventricle discovered 23 months post-implantation, conservative management with lifelong oral anticoagulation was chosen over lead extraction.
Synapse has enriched 10 related papers. Consider them for comparative context: