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Related Experiment Videos

[Unexpected malposition of a ventricular pacemaker electrode].

M Jereczek1, B Levenson

  • 1Abteilung Kardiologie und Pulmologie, Klinikum Steglitz der Freien, Universität Berlin.

Zeitschrift Fur Kardiologie
|September 1, 1992
PubMed
Summary
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A pacemaker electrode was misplaced outside the right ventricle after implantation for bradyarrhythmia. Contrast angiography confirmed extracavitary placement, requiring surgical correction.

Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • A 69-year-old patient with a history of mitral valve replacement developed symptomatic bradyarrhythmia.
  • VVI pacemaker implantation was performed to address the bradyarrhythmia.

Observation:

  • Postoperative electrocardiogram revealed a right bundle branch pattern during ventricular stimulation.
  • Fluoroscopy suggested electrode malposition outside the right ventricle.
  • Echocardiography failed to confirm the extracavitary position.

Findings:

  • Contrast angiography definitively showed the pacemaker electrode positioned outside the right ventricle, beneath the left ventricle's inferior wall, likely within the middle cardiac vein.
  • The extracavitary electrode position was successfully corrected surgically.

Related Experiment Videos

Implications:

  • This case highlights the importance of considering electrode malposition in pacemaker implantation.
  • Electrocardiographic patterns and fluoroscopy are crucial for initial detection.
  • Contrast angiography is a definitive diagnostic tool for verifying extracavitary electrode placement.
  • Prompt diagnosis and surgical correction are essential for patient safety and optimal pacemaker function.