An Unusual Cause of Transient Ischemic Attack in a Patient with Pacemaker
Pacemaker lead malposition in various locations has been described in the literature. Lead malposition in left ventricle is a rare and an underdiagnosed complication. We present a 77-year-old man with history of atrial fibrillation and pacemaker placement who was admitted for transient ischemic atta...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2014/265759 |
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| _version_ | 1832558045861773312 |
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| author | Jagadeesh Kumar Kalavakunta Vishal Gupta Basil Paulus William Lapenna |
| author_facet | Jagadeesh Kumar Kalavakunta Vishal Gupta Basil Paulus William Lapenna |
| author_sort | Jagadeesh Kumar Kalavakunta |
| collection | DOAJ |
| description | Pacemaker lead malposition in various locations has been described in the literature. Lead malposition in left ventricle is a rare and an underdiagnosed complication. We present a 77-year-old man with history of atrial fibrillation and pacemaker placement who was admitted for transient ischemic attack. He was on aspirin, beta blocker, and warfarin with subtherapeutic international normalized ratio. His paced electrocardiogram showed right bundle-branch block, rather than the typical pattern of left bundle-branch block, suggesting pacemaker lead malposition. Further, his chest X-ray and echocardiogram confirmed the pacemaker lead position in the left ventricle instead of right ventricle. He refused surgical removal of the lead and we increased his warfarin dose. Diagnosis of lead malposition in left ventricle, though easy to identify in echocardiogram, requires high index of clinical suspicion. In asymptomatic patients, surgical removal may be deferred for treatment with lifelong anticoagulation. |
| format | Article |
| id | doaj-art-819a9184a4244d28a175071f99eec3bb |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-819a9184a4244d28a175071f99eec3bb2025-02-03T01:33:20ZengWileyCase Reports in Cardiology2090-64042090-64122014-01-01201410.1155/2014/265759265759An Unusual Cause of Transient Ischemic Attack in a Patient with PacemakerJagadeesh Kumar Kalavakunta0Vishal Gupta1Basil Paulus2William Lapenna3Division of Cardiology, Michigan State University, 804 Service Road, A205 Clinical Center, East Lansing, MI, 48824, USADivision of Cardiology, Borgess Medical Center, Kalamazoo, MI 49048, USADivision of Cardiology, Borgess Medical Center, Kalamazoo, MI 49048, USADivision of Cardiology, Borgess Medical Center, Kalamazoo, MI 49048, USAPacemaker lead malposition in various locations has been described in the literature. Lead malposition in left ventricle is a rare and an underdiagnosed complication. We present a 77-year-old man with history of atrial fibrillation and pacemaker placement who was admitted for transient ischemic attack. He was on aspirin, beta blocker, and warfarin with subtherapeutic international normalized ratio. His paced electrocardiogram showed right bundle-branch block, rather than the typical pattern of left bundle-branch block, suggesting pacemaker lead malposition. Further, his chest X-ray and echocardiogram confirmed the pacemaker lead position in the left ventricle instead of right ventricle. He refused surgical removal of the lead and we increased his warfarin dose. Diagnosis of lead malposition in left ventricle, though easy to identify in echocardiogram, requires high index of clinical suspicion. In asymptomatic patients, surgical removal may be deferred for treatment with lifelong anticoagulation.http://dx.doi.org/10.1155/2014/265759 |
| spellingShingle | Jagadeesh Kumar Kalavakunta Vishal Gupta Basil Paulus William Lapenna An Unusual Cause of Transient Ischemic Attack in a Patient with Pacemaker Case Reports in Cardiology |
| title | An Unusual Cause of Transient Ischemic Attack in a Patient with Pacemaker |
| title_full | An Unusual Cause of Transient Ischemic Attack in a Patient with Pacemaker |
| title_fullStr | An Unusual Cause of Transient Ischemic Attack in a Patient with Pacemaker |
| title_full_unstemmed | An Unusual Cause of Transient Ischemic Attack in a Patient with Pacemaker |
| title_short | An Unusual Cause of Transient Ischemic Attack in a Patient with Pacemaker |
| title_sort | unusual cause of transient ischemic attack in a patient with pacemaker |
| url | http://dx.doi.org/10.1155/2014/265759 |
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