{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T16:16:24Z","timestamp":1754151384639,"version":"3.41.2"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Inadvertent temporary transvenous pacing (TTVP) of left ventricle (LV) is rare and likely underreported, posing significant embolic risk. We present a case of TTVP with atypical trajectory identified on computed tomography (CT) imaging.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>A 62-year-old male with metastatic renal cell carcinoma on chemotherapy and bifascicular block presented with symptomatic bradycardia and non\u2013ST-elevation myocardial infarction (NSTEMI), raising concerns for complete heart block on ECG. Intermittent asystole occurred during TTVP placement with appropriate capture. Post-procedure, ECG showed ventricular-paced rhythm with pseudo-right bundle branch block, and chest X-ray suggested lead placement in right ventricle; however, suboptimal echocardiography limited lead visualization. Coronary angiography revealed non-obstructive coronary artery disease. Positron emission tomography\u2013computed tomography (PET-CT), performed to evaluate immune checkpoint inhibitor myocarditis, incidentally noted TTVP wire entering right subclavian artery and traversing to LV. Patient underwent TTVP removal, endovascular repair, and pacemaker implantation; however, course was unfortunately complicated by embolic stroke and haemorrhagic conversion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Early detection and management of lead malposition remain critical to minimizing complications. Management strategies for inadvertent lead malposition (ILM) depend on duration of implantation, clinical presentation, and associated risks. This case highlights importance of recognizing this high-risk complication, preventive strategies, and evidence-based management. While existing data primarily focus on ILM in permanent devices, further research is needed to elucidate incidence, predictors, and outcomes of ILM in TTVP, particularly in resource-limited settings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf299","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T07:42:27Z","timestamp":1750750947000},"source":"Crossref","is-referenced-by-count":0,"title":["Inadvertent temporary transvenous pacing of the left ventricle: an underreported complication\u2014a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7594-9056","authenticated-orcid":false,"given":"Girish","family":"Pathangey","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Disease, Mayo Clinic Arizona , 5777 E. Mayo Blvd, USA, Phoenix, AZ 85054"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud H","family":"Abdelnabi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Disease, Mayo Clinic Arizona , 5777 E. Mayo Blvd, USA, Phoenix, AZ 85054"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramzi","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Disease, Mayo Clinic Arizona , 5777 E. Mayo Blvd, USA, Phoenix, AZ 85054"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hemalatha","family":"Narayanasamy","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Disease, Mayo Clinic Arizona , 5777 E. Mayo Blvd, USA, Phoenix, AZ 85054"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1976-6420","authenticated-orcid":false,"given":"Dan","family":"Sorajja","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Disease, Mayo Clinic Arizona , 5777 E. Mayo Blvd, USA, Phoenix, AZ 85054"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"2025071814265976000_ytaf299-B1","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1016\/j.jaccas.2021.09.008","article-title":"Inadvertent lead malposition","volume":"3","author":"Niall","year":"2021","journal-title":"JACC Case Rep"},{"key":"2025071814265976000_ytaf299-B2","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1093\/europace\/euv270","article-title":"Incidence, predictors, and outcome of inadvertent malposition of transvenous pacing or defibrillation lead in the left heart","volume":"18","author":"Ohlow","year":"2016","journal-title":"EP Europace"},{"key":"2025071814265976000_ytaf299-B3","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/0002-9149(69)90415-9","article-title":"Perforation of the interventricular septum by transvenous pacemaker catheter: diagnosis by change in pattern of depolarization on the electrocardiogram\u2217","volume":"24","author":"Thomas Stillman","year":"1969","journal-title":"Am J Cardiol"},{"key":"2025071814265976000_ytaf299-B4","first-page":"e382","article-title":"2018 ACC\/AHA\/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: a report of the American College of Cardiology\/American Heart Association task force on clinical practice guidelines and the Heart Rhythm Society","volume":"140","author":"Kusumoto","year":"2019","journal-title":"Circulation"},{"key":"2025071814265976000_ytaf299-B5","doi-asserted-by":"crossref","first-page":"3427","DOI":"10.1093\/eurheartj\/ehab364","article-title":"2021 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: developed by the task force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) with the special contribution of the European Heart Rhythm Association (EHRA)","volume":"42","author":"Glikson","year":"2021","journal-title":"Eur Heart J"},{"key":"2025071814265976000_ytaf299-B6","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1093\/europace\/euaa367","article-title":"EHRA expert consensus statement and practical guide on optimal implantation technique for conventional pacemakers and implantable cardioverter-defibrillators: endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart RhythmSociety (APHRS), and the Latin-American Heart RhythmSociety (LAHRS)","volume":"23","author":"Burri","year":"2021","journal-title":"Europace"},{"key":"2025071814265976000_ytaf299-B7","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/j.cjca.2015.03.017","article-title":"Right bundle branch block-like pattern during ventricular pacing: a surface electrocardiographic mapping technique to locate the ventricular lead","volume":"31","author":"Almehairi","year":"2015","journal-title":"Can J Cardiol"},{"key":"2025071814265976000_ytaf299-B8","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1016\/j.amjcard.2015.12.028","article-title":"Right bundle branch block-like pattern during uncomplicated right ventricular pacing and the effect of pacing site","volume":"117","author":"Tzeis","year":"2016","journal-title":"Am J Cardiol"},{"key":"2025071814265976000_ytaf299-B9","doi-asserted-by":"crossref","first-page":"e503","DOI":"10.1016\/j.hrthm.2017.09.001","article-title":"2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction","volume":"14","author":"Kusumoto","year":"2017","journal-title":"Heart Rhythm"},{"key":"2025071814265976000_ytaf299-B10","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1016\/j.jaccas.2021.08.003","article-title":"Percutaneous extraction for misplacement of pacemaker leads within the coronary artery and left ventricle","volume":"3","author":"Issei","year":"2021","journal-title":"JACC Case Rep"},{"key":"2025071814265976000_ytaf299-B11","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1016\/j.hrthm.2009.05.020","article-title":"Transvenous lead extraction: heart rhythm society expert consensus on facilities, training, indications, and patient management: this document was endorsed by the American Heart Association (AHA)","volume":"6","author":"Wilkoff","year":"2009","journal-title":"Heart Rhythm"},{"key":"2025071814265976000_ytaf299-B12","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.hrcr.2024.02.009","article-title":"Extraction of a misplaced left ventricular pacing lead with complete embolic cerebral protection and intracardiac echocardiography visualization","volume":"10","author":"Butzke da Motta","year":"2024","journal-title":"HeartRhythm Case Rep"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytaf299\/63581774\/ytaf299.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/7\/ytaf299\/63581774\/ytaf299.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/7\/ytaf299\/63581774\/ytaf299.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T18:27:10Z","timestamp":1752863230000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytaf299\/8173936"}},"subtitle":[],"editor":[{"given":"Patrick","family":"Badertscher","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Felix","family":"G\u00f6tzinger","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Teodor","family":"Serban","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Peter","family":"H\u00e4mmerle","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Piera","family":"Ricci","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,6,25]]},"references-count":12,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaf299","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2025,7]]},"published":{"date-parts":[[2025,6,25]]},"article-number":"ytaf299"}}