CTICasesMisplaced Pacemaker Lead in Left Ventricle via PFO
Imaging findings
Chest radiograph and CT show a pacemaker lead that has entered the left atrium via a patent foramen ovale (PFO), crossed the mitral valve, and resides in the left ventricular cavity rather than the right ventricle.
Key takeaways
Accidental placement of pacemaker or ICD leads into the left ventricle is an important iatrogenic complication. If undetected, it carries a high risk of thromboembolism (strokes, systemic emboli) from clots forming on the left-sided lead. Radiographs showing a posterolateral lead course on lateral view require further evaluation.
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