Paced right bundle branch block: identification and management of a malpositioned left ventricular pacemaker lead
Lugo-Adams, F.él.; RodrÃguez-Santiago, A.; Mercado-Crespo, J.é; RodrÃguez-Ospina, L.
Boletin de la Asociacion Medica de Puerto Rico 99(1): 46-50
2007
ISSN/ISBN: 0004-4849 PMID: 17616047 Document Number: 702540
Malpositioning of a permanent pacemaker lead in the left ventricle is rare. Usually, a paced right bundle branch pattern is the initial finding that fosters other confirmatory studies such as chest films and transthoracic echocardiogram. We describe the unusual case of an asymptomatic 83-year-old male patient who was incidentally found with a permanent pacemaker lead placed through the atrial septum into the left ventricle. This patient had contraindications for chronic anticoagulation and was placed on antiplatelet therapy instead. He has been well after three years without evidence of embolic episodes.