LEFT VENTRICULAR PACING DUE TO INADVERTENT IMPLANTATION OF A PERMANENT ENDOCARDIAL PACEMAKER LEAD VIA A PATENT FORAMEN OVALE

• Published in: Journal of the American College of Cardiology Vol. 71; no. 11; p. A2609
• Main Authors: Campa, Jesus Bueno, Dominguez, Luis Olmos, Castillo, Gustavo Moreno, Guevara, Milton, Escobar, Karim Juarez, Hugo, Hector, Gasca, Guevara, Gomez, Joaquin
• Format: Journal Article
• Language: English
• Published: New York Elsevier Inc 10-03-2018; Elsevier Limited
• Subjects: Antiarrhythmics; Cardiac arrhythmia; Cardiology; Electrocardiography; Electrodes; Heart; Implantation; Ventricle
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(18)33150-4

In 2005 she was admitted to our center for an episode of atrial fibrillation with rapid ventricular response, she received antiarrhythmic medication achieving rate control, and a control electrocardiogram showed 100% ventricular pacing with a complete right bundle branch block pattern; a chest X-ray showed the pacemaker electrode apparently directed into the left ventricle, so a transthoracic echocardiogram was performed, evidencing passage of the electrode through a patent foramen ovale down into the apex of the left ventricle through the mitral valve. Decision-making Considering that the patient remained asymptomatic and free of cardioembolic events, she was managed conservatively; pacing thresholds and sensitivities were measured and confirmed to be adequate, oral anticoagulation was initiated and antiarrhythmic medication was adjusted, and a pacemaker generator change procedure was performed uneventfully.