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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.

DOI:10.7759/cureus.72095
PMID:39574986
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11580108/
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/b6334593f71a/cureus-0016-00000072095-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c502/11580108/7f1cd9fe3c72/cureus-0016-00000072095-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c502/11580108/88324b0ebd35/cureus-0016-00000072095-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c502/11580108/ddaf388d1576/cureus-0016-00000072095-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c502/11580108/b6334593f71a/cureus-0016-00000072095-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c502/11580108/7f1cd9fe3c72/cureus-0016-00000072095-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c502/11580108/88324b0ebd35/cureus-0016-00000072095-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c502/11580108/ddaf388d1576/cureus-0016-00000072095-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c502/11580108/b6334593f71a/cureus-0016-00000072095-i04.jpg

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本文引用的文献

1
Unintentional Implantation of a Permanent Pacemaker Lead Across a Patent Foramen Ovale Leading to Left Ventricular Pacing.永久性起搏器导线意外经卵圆孔未闭植入导致左心室起搏
Cureus. 2023 Nov 23;15(11):e49277. doi: 10.7759/cureus.49277. eCollection 2023 Nov.
2
Inadvertent Lead Malposition in the Left Heart during Implantation of Cardiac Electric Devices: A Systematic Review.心脏电装置植入过程中左心内导线意外错位：一项系统评价
J Cardiovasc Dev Dis. 2022 Oct 20;9(10):362. doi: 10.3390/jcdd9100362.
3
Inadvertent Lead Malposition: Prevention Is Better Than Cure.
不经意的导线位置异常：预防胜于治疗。
JACC Case Rep. 2021 Nov 17;3(16):1753-1755. doi: 10.1016/j.jaccas.2021.09.008.
4
Warfarin versus direct oral anticoagulants for treating left ventricular thrombus: a systematic review and meta-analysis.华法林与直接口服抗凝剂治疗左心室血栓的系统评价和荟萃分析。
Thromb J. 2021 Feb 1;19(1):7. doi: 10.1186/s12959-021-00259-w.
5
Echocardiographic diagnosis of permanent pacemaker lead malposition in the left ventricle: A case study.超声心动图诊断左心室永久性心脏起搏器导线位置异常：病例研究。
Echocardiography. 2020 Dec;37(12):2163-2167. doi: 10.1111/echo.14938. Epub 2020 Nov 20.
6
Causes of Failure to Capture in Pacemakers and Implantable Cardioverter-defibrillators.起搏器和植入式心脏复律除颤器捕获失败的原因。
J Innov Card Rhythm Manag. 2020 Feb 15;11(2):4013-4017. doi: 10.19102/icrm.2020.110207. eCollection 2020 Feb.
7
Right bundle branch block pattern after uncomplicated right ventricular outflow tract pacing in a patient with a left sided superior vena cava and corrected tetralogy of Fallot.
Indian Pacing Electrophysiol J. 2018 Jan-Feb;18(1):39-41. doi: 10.1016/j.ipej.2017.11.005. Epub 2017 Nov 26.
8
Incidence, predictors, and outcome of inadvertent malposition of transvenous pacing or defibrillation lead in the left heart.经静脉起搏或除颤电极导线意外误置于左心的发生率、预测因素及结果
Europace. 2016 Jul;18(7):1049-54. doi: 10.1093/europace/euv270. Epub 2015 Oct 12.
9
A stroke of bad luck: left ventricular pacemaker malposition.运气不佳：左心室起搏器位置不当。
J Am Soc Echocardiogr. 2007 Nov;20(11):1316.e1-3. doi: 10.1016/j.echo.2007.03.003. Epub 2007 Jun 27.
10
Diagnosis and management of inadvertently placed pacing and ICD leads in the left ventricle: a multicenter experience and review of the literature.左心室意外置入起搏和植入式心律转复除颤器导线的诊断与处理：一项多中心经验及文献综述
Pacing Clin Electrophysiol. 2000 May;23(5):877-83. doi: 10.1111/j.1540-8159.2000.tb00858.x.