Inadvertent malposition of a permanent ventricular lead into the middle cardiac vein was misdiagnosed as lead perforation

Ann Noninvasive Electrocardiol. 2022 Jul;27(4):e12949. doi: 10.1111/anec.12949. Epub 2022 Apr 23.

Abstract

A 54-year-old man had a dual-chamber pacemaker implantation 9 years ago because of sick sinus syndrome at a different facility. The patient did not undergo any evaluation of his pacemaker for a long time with cardiologist. The patient was admitted to another hospital manifesting dyspnea and palpitation with atrial fibrillation for 1 month, and he was diagnosed with ventricular lead perforation. For further treatment, he was referred to our hospital, and an elective replacement indicator (ERI) of the battery state and a malpositioned ventricular lead into the middle cardiac vein were found. Finally, the pacing lead was left in the primary place and the pacemaker was replaced.

Keywords: malposition; middle cardiac vein; pacemaker; pacing lead.

Publication types

  • Case Reports

MeSH terms

  • Atrial Fibrillation* / diagnosis
  • Atrial Fibrillation* / etiology
  • Cardiac Pacing, Artificial
  • Coronary Sinus* / diagnostic imaging
  • Diagnostic Errors
  • Electrocardiography / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Pacemaker, Artificial* / adverse effects