ECHOCARDIOGRAPHIC LOCALIZATION OF AN INADVERTENTLY PLACED PACING CATHETER IN THE LEFT-VENTRICLE

This report describes a patient in whom a permanent transvenous pacema ker lead was placed unintentionally across the atrial septum and retai ned in the left ventricle for nearly 11 years before the error was rec ognized. A 12-lead electrocardiogram showed paced complexes with right bundle branch block configuration. This appearance raised suspicion t hat the pacemaker electrode might be in the left ventricle and this wa s confirmed by two-dimensional echocardiography. Two-dimensional echoc ardiography is useful for the diagnosis of pacing lead malplacement an d should be performed in any patient who develops right bundle branch block pattern on the surface electrocardiogram following pacemaker imp lantation.