Management of inadvertent left ventricular permanent pacing

• Published in: Journal of interventional cardiac electrophysiology Vol. 10; no. 3; pp. 237 - 240
• Main Authors: Paravolidakis, Kostas E, Hamodraka, Eftihia S, Kolettis, Theofilos M, Psychari, Stavroula N, Apostolou, Thomas S
• Format: Journal Article
• Language: English
• Published: Netherlands Springer Nature B.V 01.06.2004
• Subjects: Aged; Aged, 80 and over; Anticoagulants - therapeutic use; Aortic Valve - diagnostic imaging; Aortic Valve - pathology; Cardiac Pacing, Artificial; Disease Management; Echocardiography; Electrocardiography; Equipment Failure; Female; Heart Ventricles - diagnostic imaging; Heart Ventricles - pathology; Humans; Pacemaker, Artificial - adverse effects; Postoperative Complications - diagnosis; Postoperative Complications - drug therapy; Postoperative Complications - etiology; Subclavian Artery - diagnostic imaging; Subclavian Artery - pathology
• ISSN: 1383-875X; 1572-8595
• DOI: 10.1023/B:JICE.0000026918.50374.0d

Inadvertent implantation of a pacemaker lead in the left ventricle is an uncommon complication. We report a case of a permanent pacemaker lead inadvertently placed through the left subclavian artery, across the aortic valve into the left ventricle. A chest X-ray one month after the procedure showed an unusual course of the lead and a 12-lead ECG and a transthoracic echocardiogram confirmed the diagnosis. The patient refused surgical removal and remained on full anticoagulation. No clinical events were recorded during a 3-year follow-up. In such cases we propose life-long full anticoagulation as an alternative to surgical lead extraction.