Document Detail

Left heart pacing and cardioembolic stroke.
MedLine Citation:
PMID:  7800575     Owner:  NLM     Status:  MEDLINE    
Three patients with inadvertently positioned left heart pacemaker leads were admitted for neurological symptoms consistent with embolic stroke. In one of them, the pacemaker lead crossed the interatrial septum, the mitral valve, and entered the left ventricle. In another it was erroneously placed through the subclavian artery, across the aortic valve, and into the left ventricular chamber. In the third patient, the right ventricular lead of a DDD pacemaker was placed in the coronary sinus and the right atrial lead crossed the interatrial septum, and intermittently entered the left ventricular cavity. Once anticoagulation was initiated, symptoms resolved; they recurred when the level of anticoagulation dropped leading to a major stroke in one of the patients. Two of the patients were on aspirin at the onset of symptoms. We believe that every approach must be considered to remove the malpositioned lead. Otherwise, full dose anticoagulation must be initiated since antiplatelet therapy alone does not confer adequate protection against stroke.
M Sharifi; R Sorkin; J B Lakier
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  17     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1995-01-20     Completed Date:  1995-01-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1691-6     Citation Subset:  IM    
Department of Medicine, Lutheran General Hospital, Park Ridge, Illinois 60068.
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MeSH Terms
Aged, 80 and over
Anticoagulants / therapeutic use
Electrodes, Implanted
Heart Block / therapy
Heart Ventricles* / radiography,  ultrasonography
Intracranial Embolism and Thrombosis / etiology*,  prevention & control
Middle Aged
Pacemaker, Artificial / adverse effects*
Sick Sinus Syndrome / therapy
Reg. No./Substance:

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