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Management of symptomatic inadvertently placed endocardial leads in the left ventricle

Yasser Rodriguez1, Pablo Baltodano, Albree Tower

  • 1Division of Cardiology and Thoracic and Cardiovascular Surgery, University of Miami Hospital, Miami, FL 33125, USA.

Pacing and Clinical Electrophysiology : PACE
|June 16, 2011
PubMed

Insights

Inadvertently placed left ventricular (LV) leads require prompt management. Surgical extraction is often necessary, but percutaneous methods may be suitable in select cases to prevent serious complications.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Device Management

Background:

  • Limited data exists on managing inadvertently placed endocardial leads in the left ventricle (LV).
  • This study addresses the clinical care and management strategies for such cases.

Purpose of the Study:

  • To clarify the appropriate management of inadvertently placed LV endocardial leads.
  • To review clinical experience and published literature on this topic.

Main Methods:

  • A retrospective review of hospital charts from October 2008 to December 2010.
  • Identification of six patients with inadvertently placed LV leads via an atrial septal defect.

Main Results:

  • Six patients underwent LV lead removal (4 surgical, 2 percutaneous).
  • Presenting conditions included severe mitral regurgitation (50%), transient ischemic attack (16%), or asymptomatic (33%).
  • All patients had complete lead extraction or repositioning without immediate complications; five were alive and well at 6 months.

Conclusions:

  • Early recognition and avoidance of inadvertent LV lead placement are crucial.
  • Management typically involves surgical extraction, with percutaneous techniques as an alternative in specific situations.
  • Prompt intervention can prevent serious adverse events associated with misplaced leads.
Abstract

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