Percutaneous left ventricular endocardial leads: adverse outcomes and a percutaneous extraction case series

Figures

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  Figure 1. (A–D) Cases 1–4: AP radiographs of left ventricular endocardial leads prior to removal. Cases 1 (Panel A) and 2 (Panel B) have left ventricular endocardial leads delivered through the transatrial septal route. Case 3 (Panel C) demonstrates the left ventricular lead implanted through the transventricular septal route. Case 4 (Panel D) shows a DF4 internal cardioverter-defibrillator lead inadvertently implanted through a superior vena cava–right upper pulmonary vein connection into the left ventricular endocardium.

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  Figure 2. Case 1 (left-hand panel): reproduced with permission.7 Transoesophageal echocardiogram. The left ventricular lead is crossing the left atrium towards the posterior mitral valve leaflet at 0 degree (A). There is significant valvular regurgitation depicted by the white arrow at 120 degrees (B). Three-dimensional reconstruction shows an en-face view of the mitral valve with the white arrow demonstrating the endocardial left ventricular lead preventing complete apposition of mitral valve leaflets at the P2/A2 scallops (C). The lead penetrates the mitral valve orifice at P2 (D). Case 3: transoesophageal echocardiography demonstrating the left ventricular lead crossing the mid-ventricular septum at 33 degrees (middle panel) and 61 degrees (right-hand panel).

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