INADVERTENT MALPOSITION OF A TRANSVENOUS-INSERTED PACING LEAD IN THE LEFT-VENTRICULAR CHAMBER

Implantation of permanent transvenous cardiac pacemakers is currently in its fourth decade.(1) Over 117,000 pacemakers were implanted at 3,400 centers in the United States in 1989.(2) One of the complications associated with transvenous pacemaker implantation is the inadvertent positioning of the pacing lead in the left ventricle. Despite extensive published reports on implantation technique and endocardial hardware, there are only a few studies, all in the form of case reports, addressing this complication. This article reviews the previous publications on inadvertent left ventricular pacing and makes recommendations for prevention and early diagnosis and management of this potentially dangerous complication.