Late recognition of cardiac implantable electronic device misplacement in left ventricle: a case report.

Background: Cardiac electronic device implantation may be associated with complications. Case Summary: This is a report of inadvertent implantation of implantable cardioverter-defibrillator lead through an unrecognized sinus venosus atrial septal defect into the left ventricle that was not diagnosed early after implantation. Six months later chest x-ray showed an abnormal lead course that was confirmed with echocardiography as to be in the left ventricle. Surgical removal of the implantable cardioverter-defibrillator lead, repair of atrial septal defect, and correction of abnormal pulmonary venous connections were performed. Meanwhile, follow-up of the patient receiving a new dual chamber permanent pacemaker from the contralateral side and discussion of the aforementioned complication are addressed. Conclusion: Early diagnosis of device implantation complication is of paramount importance and prevents potential catastrophic complications. This is a report of a middle-aged woman who received a heart battery (pacemaker) without proper initial indication and faced unnecessary consequences/complications. The wire was supposed to be implanted in the right side of the heart, but due to the congenital heart disease of the patient (that was not diagnosed), the wire was erroneously passed through the congenital defect to the left side of the heart. After the diagnosis of the problem, we referred her to a heart surgeon to correct the congenital heart defect and also pull the wire out. After open surgery, a new pacemaker (with two wires) was implanted in the patient without any additional complications. Article highlights Transient loss of consciousness (syncope) may be related to cardiac causes. Adherence to guidelines-directed indications for cardiac implantable electronic devices (CIED) implantation is recommended and may obviate the need for unnecessary interventions. Venous or congenital cardiac defects may pose the physician with some challenges during the implantation of CIED. Adherence to protocols for follow-up of patients with CIED is necessary. Implantation of leads into the left side of the heart although rare should be kept in mind. This problem may remain asymptomatic or be diagnosed after a systemic embolism. Transvenous or surgical lead extraction is needed for the removal of lead erroneously implanted in the left side of the heart. Early diagnosis of complications prevents probable catastrophic complications. [ABSTRACT FROM AUTHOR]