Voltage-Associated Abdominal Pain During Bedside Temporary Transvenous Pacing: A Case Report

Area of Science:

• Cardiology
• Medical Devices

Background:

• Implantation of cardiac pacing leads requires precise positioning within the heart chambers.
• Inadvertent placement of leads, such as in the coronary sinus, can lead to suboptimal performance and complications.

Purpose of the Study:

• To describe a specific clinical presentation suggestive of inadvertent coronary sinus lead placement.
• To recommend a management strategy for this complication.

Main Methods:

• Clinical observation of patients presenting with high pacing thresholds and abdominal pain.
• Review of diagnostic tools used to confirm lead position.

Main Results:

• High pacing thresholds combined with voltage-dependent abdominal pain are key indicators of coronary sinus lead misplacement.
• Complete withdrawal and re-advancement of the lead is an effective repositioning technique.

Conclusions:

• Coronary sinus lead placement should be suspected with specific clinical findings.
• Intracavitary electrocardiography (ECG) and transthoracic echocardiography are valuable adjuncts for verifying lead placement and ensuring capture stability.