Figure 10. Lateral chest X-ray with representation of chamber
anatomy.6 The ventricular lead (b) and atrial lead (a)
are both seen projecting anteriorly.
Management of a misplaced LV lead depends on symptoms and risks of
intervention. Lead removal presents a risk of thromboembolic events, and
so surgical removal is usually withheld from asymptomatic patients or
patients in poor health. Anticoagulation therapy is currently the most
popular method of treatment. However, if anticoagulation therapy is
ineffective and thromboembolic complications occur, surgical
intervention must be considered.7 In our case,
surgical extraction was needed due to infected pacemaker pocket and
because of the mitral regurgitation that was caused by the misplaced
ventricular lead.