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An unusual cause of stroke in a patient with permanent transvenous pacemaker

Kumral Ergun1, Omac Tufekcioglu, Orhan Karabal

  • 1Department of Cardiology, Ankara Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.

Japanese Heart Journal
|November 24, 2004
PubMed

Insights

A misplaced pacemaker lead in the left ventricle caused a stroke due to cerebral embolism. Transcatheter lead extraction was considered, but the patient opted for long-term anticoagulation therapy instead.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Device Complications

Background:

  • Transvenous pacemaker leads are crucial for cardiac rhythm management.
  • Accidental malposition can lead to serious complications.

Observation:

  • A 61-year-old man experienced a stroke secondary to cerebral embolism.
  • The embolism resulted from a permanently placed transvenous pacemaker lead inadvertently positioned in the left ventricle.
  • Electrocardiogram and chest X-ray suggested left-sided lead placement, confirmed by transthoracic echocardiography.

Findings:

  • Inadvertent transvenous pacemaker lead malposition in the left ventricle.
  • Cerebral embolism as a direct consequence of lead malposition.
  • Patient decision to pursue lifelong anticoagulation over transcatheter lead extraction.

Implications:

  • Highlights the critical need for precise pacemaker lead placement.
  • Underscores the potential for severe neurological complications from device malposition.
  • Demonstrates alternative management strategies for device-related complications.

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