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Updated: May 19, 2026
Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Implantable cardiac devices with patent foramen ovale--a risk factor for cardioembolic stroke?
Christopher V DeSimone1, Daniel C DeSimone, Nikhil A Patel
1Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Insights
A patent foramen ovale (PFO) is common in patients with cardiac devices. Thrombus on device leads may cause stroke by crossing a PFO, as seen in three case studies.
Area of Science:
- Cardiology
- Neurology
- Medical Devices
Background:
- A patent foramen ovale (PFO) is present in approximately 25% of patients with implanted cardiac devices.
- Intravascular leads of cardiac devices can develop thrombus.
- The potential link between PFO, lead thrombus, and cerebral embolic events remains unclear.
Abstract:
A quarter of patients with implanted cardiac devices have a patent foramen ovale (PFO). Thrombus is frequently noted on intravascular leads that in the presence of a PFO could result in cerebral vascular embolic events. However, whether this mechanism of stroke occurs is not clearly known. We report three patients with PFO, implanted leads with thrombus, and stroke, including a patient where thrombus partially attached to the lead was seen traversing the PFO.
