Two-dimensional echocardiography for the diagnosis of interventricular septum perforation by a temporary pacing catheter.
This case study describes a patient with complete heart block inadvertently paced from the left ventricular posterior wall due to perforation of interventricular septum by a temporary pacing catheter. This is a rare but potentially fatal complication of pacing. The frontal chest radiograph neither identified abnormalities nor could determine the exact site of the catheter tip. The electrocardiogram revealed a right bundle branch block pattern. Echocardiography was performed immediately at bedside and the diagnosis was made. The temporary pacing catheter was removed without complications and, the next day, the patient underwent permanent pacemaker implantation. Given its noninvasiveness and availability, echocardiography is a highly effective means of assessing pacemaker complications such as catheter perforation.
Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Kuan-Hung
KH
Yeh
Chi-Wen
CW
Cheng
Li-Tang
LT
Kuo
Kuo-Chun
KC
Hung
D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000379:methods; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects* / Q000379:methods; D004452:Echocardiography; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D018658:Ventricular Septal Rupture / Q000000981:diagnostic imaging* / Q000209:etiology