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Updated: Jul 5, 2026

Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence

Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence

Published on: December 23, 2022

Avoiding pacemaker lead entrapment during PFO closure.

Marcin Demkow¹, Lukasz A Malek, Witold Ruzyllo

¹1st Department of Coronary Artery Disease and 2nd Catheterization Laboratory, Institute of Cardiology, Warsaw, Poland. mdemkow@ikard.pl

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions

|April 17, 2008

Summary

Transcatheter closure of patent foramen ovale (PFO) in patients with pacemakers is challenging. A novel technique successfully repositioned a pacemaker lead, enabling safe PFO device implantation.

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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

Area of Science:

Cardiology
Interventional Cardiology
Medical Devices

Background:

Patent foramen ovale (PFO) closure is a treatment for cryptogenic stroke.
Dual-chamber pacemakers are common in patients with cardiac conditions.
Co-existence of PFO and pacemakers presents unique procedural challenges.

Observation:

A patient with a pacemaker required transcatheter PFO closure.
The pacemaker's ventricular lead interfered with Amplatzer occluder deployment.
Lead proximity prevented optimal occluder positioning and secure placement.

Findings:

A modified pigtail catheter was used to manipulate the pacemaker lead.
The lead was successfully moved away from the PFO.
This maneuver facilitated the successful implantation of the PFO occluder.

Implications:

This technique offers a solution for pacemaker lead interference during PFO closure.
It may improve procedural success rates in patients with co-existing PFO and pacemakers.
This approach enhances patient safety and treatment options for cryptogenic stroke.