[Misplaced implantation of a pacemaker electrode in a coronary vein].

The wrong implantation of pacemaker electrodes into a coronary vein is in most cases accidentally diagnosed when thoracic X-ray pictures are made in two planes. It is to be excluded not with certainly in the sagittal ray-path of the thoracic X-ray picture and in the ECG of the extremities. The diagnostic criteria for the recognition of a false position are the end of the electrode which is in the frontal ray-path directed dorsally to the spine and a right bundle branch block in the ECG existing since implantation. Pacemaker-synchronous contractions of the diaphragm as well as an increased already at the time of implantation stimulus threshold may be references. Description of an own observation with an up to now long-term stimulation through a coronary vein without complications lasting 15 months, in which a correction of the position is not regarded as necessary due to the regular function of the pacemaker.