Transvenous pacemaker lead malposition in the left ventricle is a rare complication of pacemaker implantation however, at the moment of diagnosis poses the serious therapeutic problem. The usual morphology for paced events originating from the right ventricle has a left bundle branch block pattern, but sometimes right bundle branch block (RBBB) configuration is identified. The report describes two cases of RBBB configuration in the electrocardiogram (ECG) after pacemaker implantation. Case 1 demonstrates a female with unintentional pacemaker lead placement in the left ventricle through patent foramen ovale. Lead malposition was diagnosed accidentally during echocardiographic study (ECHO), 6 years after implantation. Case 2 concerns a man with a RBBB pacing configuration, but with correct pacemaker lead position in the right ventricle. Authors analyze these cases in connection with other publicized reports in order to find the safe algorithm for intraoperative estimation of correct pacemaker lead location. The following algorithm of procedures during pacemaker implantation is proposed to avoid the lead malposition in the left ventricle. First, obligatory perform 12-lead ECG in pace mode during surgery or immediately after it. Second, in case of RBBB pattern in post implant ECG, make ECHO for precise lead position description.
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Pediatr Cardiol
January 2025
Cardiothoracic Department, Children's Health Ireland at Crumlin, Dublin, Ireland.
Lead strangulation is a dangerous complication of epicardial pacemaker insertion. This complication has been increasingly highlighted lately. Our institution has recently identified four cases over the past five years.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Department of Cardiology, Azorg, Merestraat 80, 9300 Aalst, Belgium.
Background: Patients after transcatheter pulmonary valve implantation (TPVI) are at increased risk for infective prosthetic valve endocarditis. Diagnosis of infective endocarditis (IE) following TPVI is particularly difficult due to impaired visualization of the transcatheter pulmonary valve (TPV) with echocardiography [Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, et al. 2023 ESC guidelines for the management of endocarditis.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Department of Cardiology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-Ku, Yokohama city, Kanagawa 236-0004, Japan.
Background: Coronary sinus (CS) lead placement in persistent left superior vena cava (PLSVC) cases is challenging because of the poor backup force of the guiding catheter within the enlarged CS. Active fixation Quadripolar leads (Attain Stability™ Quad 4798, Medtronic) can expand choice to CS branches with limited access; however, no cases of anchoring to the main body of the CS have been published to date.
Case Summary: We describe a case of cardiac resynchronization therapy pacemaker upgrade in a 79-year-old female who developed pacing-induced cardiomyopathy after pacemaker implantation via the right superior vena cava (SVC) for atrioventricular block eight years ago wherein PLSVC was revealed during the procedure.
Catheter Cardiovasc Interv
January 2025
Department of Cardiology, Ageo Central General Hospital, Saitama, Japan.
Background: Intravascular lithotripsy (IVL), that generates shockwaves through spark gap discharge between emitters, has been increasingly used to treat severely calcified coronary artery lesions. However, there is a question as to whether IVL has no electrical effects on endocardial tissues or cardiac implantable devices (CIEDs).
Aims: The aim of this study was to investigate the effects of IVL-induced intracardiac potentials on cardiac electrophysiology and CIEDs.
BMJ Case Rep
January 2025
Cardiology, AIIMS, New Delhi, India
A young man in his 30s presented to us with multiple episodes of syncope and exertional dyspnoea for the last 2 weeks. He was diagnosed with squamous cell carcinoma of the lower one-third of the oesophagus in 2021 for which he was treated with neoadjuvant chemoradiotherapy, followed by McKeown oesophagectomy. At 2-year follow-up, he had developed a soft tissue swelling in the scalp, which was diagnosed as a tumour recurrence and radiotherapy was initiated.
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