Bodian Malick, Aw Fatou, Bamba Mouhamadou Ndiaye, Kane Adama, Jobe Modou, Tabane Alioune, Mbaye Alassane, Sarr Simon Antoine, Diao Maboury, Sarr Moustapha, Bâ Serigne Abdou
Department of Cardiology, Aristide Le Dantec Teaching Hospital.
Int Med Case Rep J. 2013 Jul 5;6:29-32. doi: 10.2147/IMCRJ.S45784. Print 2013.
Routine implantation of pacemakers and implantable cardioverter defibrillators is not commonly associated with complications. However, in some cases we see misplacement of pacemaker leads which is most often related to the presence of underlying cardiac anomalies. We report the case of misplacement of a pacemaker lead into the left ventricle of a 56-year-old patient paced in VVI/R mode and with a tined type pacemaker lead because of a symptomatic complete atrioventricular block. Electrocardiogram showed a pacemaker-generated rhythm with a right bundle branch block pattern. Chest X-ray showed the pacemaker lead located relatively high in relation to the diaphragm. Echocardiography visualized the pacemaker lead in the left heart chambers (atrium and ventricle), hence confirming its aberrant course. Further, the defect causing its passage to the left heart chambers was a sinus venosus atrial septal defect. The patient reported no complication related to the misplacement of the lead. After a brief period of oral anticoagulation, the lead was inserted into the right ventricle by percutaneous technique.
常规植入起搏器和植入式心脏复律除颤器通常不会引发并发症。然而，在某些情况下，我们会看到起搏器导线位置异常，这通常与潜在的心脏异常有关。我们报告了一例56岁患者的起搏器导线误置入左心室的病例，该患者因症状性完全房室传导阻滞采用VVI/R模式起搏，使用的是有翼型起搏器导线。心电图显示起搏器产生的节律伴有右束支传导阻滞图形。胸部X线显示起搏器导线相对于膈肌位置较高。超声心动图显示起搏器导线位于左心腔（心房和心室），从而证实了其异常走行。此外，导致其进入左心腔的缺损是静脉窦型房间隔缺损。患者未报告与导线误置相关的并发症。经过短暂的口服抗凝治疗后，通过经皮技术将导线插入右心室。
