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Navigating Misplaced Leads: A Case of Left Ventricle (LV) Lead Placement via a Patent Foramen Ovale (PFO) in a Dual-Chamber Permanent Pacemaker (PPM)

Year: 2025

Type: article

Abstract: Pacemaker lead misplacement is a rare but clinically significant complication of pacemaker implantation. We present the case of a male patient in his 80s with a permanent pacemaker (PPM) who was found to have an inadvertently misplaced right ventricular (RV) lead coursing through a patent foramen ovale (PFO) into the left ventricle (LV). The patient presented with progressive dyspnoea and was found to have moderate mitral regurgitation related to lead interference with valve closure. Imaging modalities confirmed the lead's anomalous position. A multidisciplinary discussion concluded that conservative management with anticoagulation was the safest approach. This case highlights the importance of multimodal imaging in identifying lead misplacement and the clinical implications of inadvertent LV pacing. Furthermore, it underscores the importance of routine post-implantation assessment to detect lead displacement, which can often occur without symptoms. Early identification through systematic evaluation is essential to prevent complications and ensure optimal device function.

Source: Cureus

DOI: 10.7759/cureus.82835

Authors: Jhiamluka Solano, Dalia Admed, Aia Ahmed, Shuja Abbas, Adnan Ahmed, Renjith Antony

Institutions: Scunthorpe General Hospital, Royal College of Physicians, University of Hull, Castle Hill Hospital

Language: English

Topic: Cardiac pacing and defibrillation studies

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4409698868