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Angiology
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Transvenous Permanent Left Ventricular Pacing

A Case Report

Wen Lieng Lee

Division of Cardiology, Department of Medicine, Veterans General Hospital

Chi Woon Kong

Division of Cardiology, Department of Medicine, Veterans General Hospital

Lee Shing Chu

Department of Nuclear Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China

Jer Young Liou

Division of Cardiology, Department of Medicine, Veterans General Hospital

Min Ren Lin

Division of Cardiology, Department of Medicine, Veterans General Hospital

Wan Leong Chan

Division of Cardiology, Department of Medicine, Veterans General Hospital

Mau Song Chang

Division of Cardiology, Department of Medicine, Veterans General Hospital

This case report presents a patient who inadvertently received transvenous permanent left ventricular pacing through an unexpected atrial septal defect. This lead malpositioning was proved by two-dimensional and transesophageal echocardiography. The abnormal pattern of electric activation was demonstrated by radionuclide phase image analysis. He has been followed up for a total of forty-three months with antiplatelet therapy and has been free from systemic embolic phenomena. A simple and readily available method that could lead to early recognition of lead malpositioning is reiterated and the various causes, methods of detection, and prognosis of left ventricular pacing are discussed.

Angiology, Vol. 46, No. 3, 259-264 (1995)
DOI: 10.1177/000331979504600310
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