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Cerebral embolism due to left ventricular pacemaker lead: removal with cardiopulmonary bypass

A Liebold1, H Aebert, M Muscholl

  • 1Department of Thoracic and Cardiovascular Surgery, University Hospital, Regensburg, Germany.

Pacing and Clinical Electrophysiology : PACE
|December 1, 1994
PubMed

Insights

A misplaced cardiac pacemaker lead in the left ventricle caused a delayed cerebral embolism 3 years post-implantation. Surgical removal via a transaortic approach successfully treated this rare complication.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Device Technology

Background:

  • Cardiac pacemaker lead malposition, particularly in the left ventricle, is a known risk factor for thromboembolic events.
  • Such complications can manifest both early and late after device implantation, posing significant clinical challenges.

Observation:

  • A case is presented of a patient experiencing cerebral embolism.
  • This event occurred three years after the initial implantation of a cardiac pacemaker lead.
  • The embolism was attributed to an inadvertently misplaced left ventricular electrode.

Findings:

  • The study details a rare instance of late-onset cerebral embolism.
  • The cause was identified as a cardiac pacemaker lead lodged in the left ventricle.
  • Successful retrieval of the misplaced lead was achieved using a transaortic approach with extracorporeal circulation.

Implications:

  • This case highlights the potential for delayed thromboembolic complications from pacemaker lead malposition.
  • It underscores the importance of careful lead placement and surveillance for late complications.
  • Transaortic lead extraction is a viable option for managing such rare but serious adverse events.

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