[Perforation of a temporary transvenous pacemaker electrode in the left hemithorax. Diagnostic value of echocardiography].
We report a rare malposition of a temporary transvenous pacemaker electrode. A pacemaker electrode was inserted in a patient with acute postero-lateral infarction. The correct position of the electrode tip was controlled by fluoroscopy. Capture and sensing functions worked regularly. Four days later, angina-pectoris-like complaints occurred again. Chest x-ray film revealed the tip of the electrode in the left hemithorax. Echocardiographic assessment showed a penetration through the interventricular septum into the left ventricle. The electrode passed the left ventricle, penetrated the anterior-lateral free wall and reached the left pleural space. A thoracotomy was performed immediately. The electrode was retracted under visual control. A spurting arterial bleeding from the left ventricle was secured with a purse-string ligature. This case report emphasizes the value of echocardiography in the evaluation of a malposition of a transvenous pacemaker electrode.
Erlemeier
H H
HH
Abt. Kardiologie, Universitäts-Krankenhaus Eppendorf.
Wolf
W
W
Harland
A
A
Schier
H
H
D004452:Echocardiography; D004562:Electrocardiography; D004567:Electrodes, Implanted; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000293:injuries*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D010138:Pacemaker, Artificial
Perforation einer passageren transvenösen Schrittmacherelektrode in den linken Hemithorax. Diagnostische Wertigkeit der Echokardiographie.