TITLE:
Inadvertent Lead Malposition in the Left Ventricle during Permanent Ventricular Pacing about One Case
AUTHORS:
Khadidiatou Dia, Waly Niang Mboup, Serigne Cheikh Tidiane Ndao, Mame Madjiguene Ka, Rabab Yassine, Djibril Marie Ba, Demba Ware Balde, Mouhamed Cherif Mboup
KEYWORDS:
Lead Malposition, Left Ventricle Lead, Right Bundle Branch Block, Ventricu-lar Pacing, Transthoracic Echocardiography
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.13 No.11,
November
20,
2023
ABSTRACT: 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.