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靠右:临时起搏导线意外置入左心室。

Keep Right: Inadvertent Placement of a Temporary Pacing Lead in the Left Ventricle.

作者信息

Shanker Dinesh Abhijeeth, Briggs Howard, Chacko Abraham

机构信息

Cardiology, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, GBR.

出版信息

Cureus. 2024 Oct 22;16(10):e72095. doi: 10.7759/cureus.72095. eCollection 2024 Oct.

Abstract

Inadvertent lead malposition (ILM) of a temporary pacing wire is a rare complication that can occur during pacemaker insertion. We report a case of a 40-year-old man who presented late following an inferior ST segment elevation myocardial infarction. Temporary cardiac pacing was performed for symptomatic complete heart block. A 12-lead electrocardiogram (ECG) on the following day showed a paced QRS complex with right bundle branch block pattern. Malposition of the pacing wire was suspected to be in the left ventricle and confirmed by chest X-rays and an echocardiogram. This article discusses the occurrence of inadvertent left ventricle pacing and its management. Early recognition with the help of echocardiogram and ECG will aid in reducing the incidence of such complications.

摘要

临时起搏导线意外位置异常(ILM)是起搏器植入过程中可能发生的一种罕见并发症。我们报告一例40岁男性,该患者在发生下壁ST段抬高型心肌梗死后就诊较晚。因有症状的完全性心脏传导阻滞而进行了临时心脏起搏。次日的12导联心电图(ECG)显示起搏的QRS波群呈右束支传导阻滞图形。怀疑起搏导线位置异常在左心室,胸部X线和超声心动图证实了这一点。本文讨论了意外左心室起搏的发生情况及其处理。借助超声心动图和ECG进行早期识别将有助于降低此类并发症的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c502/11580108/7f1cd9fe3c72/cureus-0016-00000072095-i01.jpg

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