[Unexpected malposition of a ventricular pacemaker electrode].
Ten years after mitral-valve replacement, a 69-year-old patient underwent VVI pacemaker implantation because of symptomatic bradyarrhythmia. Postoperatively, the electrocardiogram showed a right bundle branch pattern under ventricular stimulation while the threshold was optimal. Under fluoroscopy, we suspected a malposition of the electrode outside the right ventricle in the LAO and lateral view. This could not be verified by echocardiography, whereas contrast angiography of the right ventricle proved the extracavitary position of the electrode under the inferior wall of the left ventricle, probably in the middle cardiac vein. The electrode position was operatively corrected without complications. We discuss different ways of malposition and their detection by considering electrocardiographic configuration and fluoroscopy in LAO and lateral view.
Jereczek
M
M
Abteilung Kardiologie und Pulmologie, Klinikum Steglitz der Freien, Universität Berlin.
Levenson
B
B
D000368:Aged; D003952:Diagnostic Imaging; D004562:Electrocardiography; D004567:Electrodes, Implanted; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis* / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D010138:Pacemaker, Artificial; D011183:Postoperative Complications / Q000175:diagnosis* / Q000601:surgery; D012086:Reoperation
Unerwartete Fehllage einer ventrikulären Schrittmacherelektrode.