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This phenomenon is caused by the ventricular lead unintentionally crossing a pre\u2010existing patent foremen ovale, septal defects (atrial or ventricular) or directly from the aorta via an accidental subclavian puncture resulting in the lead implanting into the left ventricle. While this is a rare occurrence we report, the incidental finding of pacemaker lead malposition during a routine follow\u2010up transthoracic echocardiogram and the benefits of three\u2010dimensional transesophageal echocardiography in this patient prior to lead extraction.<\/jats:p>","DOI":"10.1111\/echo.14938","type":"journal-article","created":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T10:03:21Z","timestamp":1605953001000},"page":"2163-2167","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Echocardiographic diagnosis of permanent pacemaker lead malposition in the left ventricle: A case study"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5756-5243","authenticated-orcid":false,"given":"Peter","family":"Luke","sequence":"first","affiliation":[{"name":"School of Biomedical, Nutritional and Sport Sciences Newcastle University Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ewen","family":"Shepherd","sequence":"additional","affiliation":[{"name":"Echocardiography Department Freeman Hospital Newcastle upon Tyne UK"},{"name":"Electrophysiology Department Freeman Hospital Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Irvine","sequence":"additional","affiliation":[{"name":"Echocardiography Department Freeman Hospital Newcastle upon Tyne UK"},{"name":"Electrophysiology Department Freeman Hospital Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rae","family":"Duncan","sequence":"additional","affiliation":[{"name":"Echocardiography Department Freeman Hospital Newcastle upon Tyne UK"},{"name":"Electrophysiology Department Freeman Hospital Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,20]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejechocard\/jen187"},{"key":"e_1_2_5_3_1","doi-asserted-by":"crossref","first-page":"bcr2012008312","DOI":"10.1136\/bcr-2012-008312","article-title":"Inadvertent left ventricular pacing through a patent foramen ovale: identification, management and implications for postpacemaker implantation checks","volume":"2013","author":"Wynn GJ","year":"2013","journal-title":"BMJ Case Rep"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv270"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afr152"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2000.tb00858.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/1749-8090-9-54","article-title":"Pacemaker lead malpositioning led to subsequent ischemic strokes despite antiplatelet and anticoagulation therapy","volume":"9","author":"Rath C","year":"2014","journal-title":"J Cardiothor Surg"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2011.03146.x"},{"issue":"2","key":"e_1_2_5_9_1","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1510\/icvts.2008.190793","article-title":"Malpositioning of a pacemaker lead to the left ventricle accompanied by posterior mitral leaflet injury","volume":"8","author":"Seki H","year":"2009","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.541631"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.819"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrcr.2019.10.020"},{"issue":"1","key":"e_1_2_5_13_1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.3949\/ccjm.85a.17012","article-title":"Detecting and managing device leads inadvertently placed in the left ventricle","volume":"85","author":"Trohman RG","year":"2018","journal-title":"Clevel Clin J Med"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.14558"},{"issue":"3","key":"e_1_2_5_15_1","doi-asserted-by":"crossref","first-page":"927","DOI":"10.4081\/monaldi.2018.927","article-title":"A \u201clong\u2010standing\u201d malpositioned pacing lead. Long\u2010term follow\u2010up after extraction","volume":"88","author":"Sarubbi B","year":"2018","journal-title":"Monaldi Arch Chest Dis"},{"key":"e_1_2_5_16_1","doi-asserted-by":"crossref","DOI":"10.1055\/s-0034-1367441","article-title":"Laser\u2010based lead extraction of an accidentally left ventricular placed ICD lead","volume":"62","author":"Burger H","year":"2014","journal-title":"Thorac Cardiovasc Surg"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2009.05.020"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.14938","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/echo.14938","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.14938","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,17]],"date-time":"2024-08-17T20:59:45Z","timestamp":1723928385000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.14938"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,20]]},"references-count":16,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1111\/echo.14938"],"URL":"https:\/\/doi.org\/10.1111\/echo.14938","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,20]]},"assertion":[{"value":"2020-10-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}