Saved by anticoagulants: Incidental discovery of a misplaced defibrillator lead 6 years after implantation. Inadvertent lead placement inside the left ventricular cavity

Figures

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  FIGURE 1. Normal ICD placement, in which the lead is screwed into the right ventricle

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  FIGURE 2. AP chest X‐ray showing ICD shock lead in an apparently good position

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  FIGURE 3. Apical 4‐chamber view showing the ICD shock lead going through the mitral valve into the left ventricular cavity. Note the moderately to severely dilated right ventricle with hypertrophied wall indicating significant pulmonary hypertension. Bi‐atrial enlargement is also noted

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  FIGURE 4. Apical 3‐chamber view showing the ICD shock lead clearly going through the mitral valve into the left ventricle

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  FIGURE 5. Subcostal view showing the ICD shock lead coursing through a sinus venosus defect from the right atrium (RA) to the left atrium (LA) into the mitral valve (MV)

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  FIGURE 6. Lateral chest X‐ray of a patient with inadvertent left ventricular lead placement. The lead is clearly seen posteriorly, indicating migration to the left ventricle