Document Detail

Paradoxic embolism due to altered hemodynamic sequencing following transvenous pacing.
MedLine Citation:
PMID:  1710053     Owner:  NLM     Status:  MEDLINE    
A young patient, who experienced a cerebral embolic event 30 days after transvenous pacemaker lead placement, is reported. This patient had previously been paced with an epicardial lead without evidence of right to left intracardiac shunt. However, hemodynamic evaluation post-embolism demonstrated a marked temporal disparity of the pulmonary and systemic ventricles. This phasic divergence resulted in a brief reversal of right and left ventricular pressure ratios, and a paradoxic intracardiac shunt at a small ventricular septal defect. The potential for similar events in the presence of any defect of the atrial or ventricular septum mandates caution in the use of transvenous pacemaker leads in such patients.
M J Silka; M J Rice
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  14     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1991 Apr 
Date Detail:
Created Date:  1991-06-28     Completed Date:  1991-06-28     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:  499-503     Citation Subset:  IM    
University Arrhythmia Service, Oregon Health Sciences University, Portland 97201.
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MeSH Terms
Blood Pressure
Cardiac Output
Cardiac Pacing, Artificial / adverse effects*,  methods
Heart Septal Defects, Ventricular / complications*,  physiopathology
Intracranial Embolism and Thrombosis / etiology*

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