Long-term left ventricular pacing

A 57-year-old female was implanted with a Biotronik Pikes VVI pulse generat or. During her follow-up period right bundle-branch block was observed. The refore further posteroanterior and lateral chest X-ray and echocardiography were performed. Only the transoesophageal echocardiography showed exactly the abnormal pathway of the electrode through the foramen ovate apertum to the left side of the heart. Abnormal electrode position can create serious complications, however, our patient remained free of symptoms throughout he r 5 year follow-up.