Kewcharoen J, Contractor T, Kotak K, Prasad V. Management of an Inadvertently Placed Transarterial Pacemaker Lead in the Left Ventricle: A Step-by-step Approach.
J Innov Card Rhythm Manag 2023;
14:5482-5487. [PMID:
37388424 PMCID:
PMC10306246 DOI:
10.19102/icrm.2023.14064]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/20/2022] [Indexed: 07/01/2023] Open
Abstract
Inadvertent lead misplacement in the left ventricle can lead to thromboembolic events, valvular damage, and endocarditis. We present a case of an inadvertently placed transarterial pacemaker lead in the left ventricle in a patient who underwent percutaneous lead removal. After a multidisciplinary team discussion involving cardiac electrophysiology and interventional cardiology as well as a discussion of treatment options with the patient, it was decided to proceed with pacemaker lead removal with the Sentinel™ Cerebral Protection System (Boston Scientific, Marlborough, MA, USA) to prevent thromboembolic events. The patient tolerated the procedure well without post-procedural complications and was discharged the next day on oral anticoagulation. We also present a step-by-step approach to perform lead removal with the use of Sentinel™, emphasizing mitigating the stroke and bleeding risks in this patient setting.
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