Misplacement of pacemaker leads: How to avoid and how to approach?
misplaced lead
pacemaker lead complications
ventricular lead
Journal
Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944
Informations de publication
Date de publication:
12 2023
12 2023
Historique:
revised:
14
10
2023
received:
27
07
2023
accepted:
22
10
2023
medline:
17
12
2023
pubmed:
1
11
2023
entrez:
1
11
2023
Statut:
ppublish
Résumé
The use of cardiac implantable electronic devices has increased in recent years due to factors such as a growing population, increased life expectancy, and improved access to healthcare services. In parallel with this trend, complications related to pacemakers have also increased. One of the most important and preventable complications among these is lead misplacement. Misplacement of a permanent pacemaker lead in the LV can lead to a variety of complications, including damage to the heart muscle, arrhythmias, blood clotes and cerebrovascular events. It is recommended to use the fluoroscopic 40° LAO view during implantation. That view clearly defines the interatrial and interventricular septum. Right bundle branch block pattern on ECG is an important clue to suspected misplaced lead. In addition to the postero-anterior (PA) projection of x-ray, the latero-lateral (LL) projection provides a clearer view of lead malposition. In the LL view, the tip of an incorrectly positioned LV lead is characteristically directed toward the spine. If diagnosed soon after implantation, percutaneous lead extraction can reduce the risk of future thromboembolic events without the need for lifelong anticoagulation. It should be noted that in cases with a lead in the LV for a long time, lead removal is not the primary recommendation. Patient-based approach should be fundamental.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1662-1664Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
Raatikainen MJ, Arnar DO, Merkely B, Camm AJ, Hindricks G. Access to and clinical use of cardiac implantable electronic devices and interventional electro- physiological procedures in the European Society of Cardiology Countries: 2016 Report from the European Heart Rhythm Association. Europace. 2016;18:iii1-79.
Elens M. Misplaced arterial pacemaker lead. Eur J Vasc Endovasc Surg. 2020;60:895. doi:10.1016/j.ejvs.2020.07.002
Kewcharoen J, Contractor T, Kotak K, Prasad V. Management of an inadvertently placed transarterial pacemaker lead in the left ventricle: a step-by-step approach. J Innov Card Rhythm Manag. 2023;14:5482-5487. 10.19102/icrm.2023.14064. Published 2023 Jun 15.
Kosmidou I, Karmpaliotis D, Kandzari DE, Dan D. Inadvertent transarterial lead placement in the left ventricle and aortic cusp: percutaneous lead removal with carotid embolic protection and stent graft placement. Indian Pacing Electrophysiol J. 2012;12:269-273. doi:10.1016/s0972-6292(16)30565-4
Trohman RG, Sharma PS. Detecting and managing device leads inadvertently placed in the left ventricle. Cleve Clin J Med. 2018;85:69-75. doi:10.3949/ccjm.85a.17012
Goldenberg G, Iakobishvili Z, Strasberg B. Electrocardiographic algorithm for the diagnosis of inadvertent implantation of permanent pacemaker lead in the left ventricular cavity. Ann Noninvasive Electrocardiol. 2013;18:294-296. doi:10.1111/anec.12021
Wynn GJ, Weston C, Cooper RJ, Somauroo JD. Inadvertent left ventricular pacing through a patent foramen ovale: identification, management and implications for postpacemaker implantation checks. BMJ Case Rep. 2013;2013:bcr2012008312. doi:10.1136/bcr-2012-008312 Published 2013 Jun 27
Erdem A, Torun A, Kılıç Ş, Cinar T, Uzun M, Orhan AL. Inadvertent misplacement of pacemaker lead presented with acute ischemic stroke [published online ahead of print, 2023 Jun 28]. Pacing Clin Electrophysiol. 2023. doi:10.1111/pace.14772
Mazzone P, Radinovic A. Lead extraction-aspects beyond the procedure. Int J Cardiol. 2018;250:150-151. doi:10.1016/j.ijcard.2017.09.007 Epub 2017 Sep 13. PMID: 29033009
Bongiorni MG, Kennergren C, Butter C, et al. The European Lead Extraction ConTRolled (ELECTRa) study: a European Heart Rhythm Association (EHRA) Registry of Transvenous Lead Extraction Outcomes. Eur Heart J. 2017;38:2995-3005. doi:10.1093/eurheartj/ehx080
Wilkoff BL, Love CJ, Byrd CL, et al. Transvenous lead extraction: heart rhythm society expert consensus on facilities, training, indications, and patient management: this document was endorsed by the American Heart Association (AHA). Heart Rhythm. 2009;6:1085-1104. doi:10.1016/j.hrthm.2009.05.020