title: Paced right bundle branch block: identification and management of a malpositioned left ventricular pacemaker lead.
abstract: Malpositioning of a permanent pacemaker lead in the left ventricle is rare. Usually, a paced right bundle branch pattern is the initial finding that fosters other confirmatory studies such as chest films and transthoracic echocardiogram. We describe the unusual case of an asymptomatic 83-year-old male patient who was incidentally found with a permanent pacemaker lead placed through the atrial septum into the left ventricle. This patient had contraindications for chronic anticoagulation and was placed on antiplatelet therapy instead. He has been well after three years without evidence of embolic episodes.
authors.affiliation: Cardiology Section, Department of Medicine, Veterans Administration Medical Center of San Juan, Puerto Rico.
authors.forename: Félix
authors.initials: F
authors.lastname: Lugo-Adams
authors.forename: Angel
authors.initials: A
authors.lastname: Rodríguez-Santiago
authors.forename: Josué
authors.initials: J
authors.lastname: Mercado-Crespo
authors.forename: Luis
authors.initials: L
authors.lastname: Rodríguez-Ospina
mesh_terms: D000369:Aged, 80 and over; D002037:Bundle-Branch Block / Q000628:therapy*; D005547:Foreign Bodies / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects