title: Management of inadvertent left ventricular permanent pacing.
abstract: Inadvertent implantation of a pacemaker lead in the left ventricle is an uncommon complication. We report a case of a permanent pacemaker lead inadvertently placed through the left subclavian artery, across the aortic valve into the left ventricle. A chest X-ray one month after the procedure showed an unusual course of the lead and a 12-lead ECG and a transthoracic echocardiogram confirmed the diagnosis. The patient refused surgical removal and remained on full anticoagulation. No clinical events were recorded during a 3-year follow-up. In such cases we propose life-long full anticoagulation as an alternative to surgical lead extraction.
authors.affiliation: 2nd Department of Cardiology, Nikea General Hospital, 3 Madouvalou Street, Nikea, 18454 Athens, Greece.
authors.forename: Kostas E
authors.initials: KE
authors.lastname: Paravolidakis
authors.forename: Eftihia S
authors.initials: ES
authors.lastname: Hamodraka
authors.forename: Theofilos M
authors.initials: TM
authors.lastname: Kolettis
authors.forename: Stavroula N
authors.initials: SN
authors.lastname: Psychari
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Apostolou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology; D002304:Cardiac Pacing, Artificial; D019468:Disease Management; D004452:Echocardiography; D004562:Electrocardiography; D004868:Equipment Failure; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D000925:Anticoagulants