Cardiac pacemaker lead placement: Do you need a lateral chest radiograph?

Received 2 November 2009; received in revised form 12 January 2010; accepted 16 March 2010. published online 26 April 2010.

Abstract

We present a case of an uneventful dual chamber permanent pacemaker (PPM) implantation which, on the follow-up chest radiograph (CXR), was reported as good lead tip placement and no complications. The patient was re-admitted 7 months later. The PA CXR appearances were unchanged but, in the lateral projection, the ventricular lead tip was projected posteriorly within the heart, most likely within the LV. This was confirmed by CT showing the ventricular lead tip within the LV having passed through a patent foramen ovale (PFO).

Keywords: Pacemaker, PPM, Lateral chest radiograph, CXR, Complication, CT

Department of Radiology and Diagnostic Imaging, University of Alberta Hospitals, Edmonton, Alberta, Canada

Corresponding author. 0A8.51 ABACUS Research Centre, WMC, 8440, 112 Street, Edmonton, AB, Canada T6G 2B7. Tel.: +1 780 4076817; fax: +1 780 4073075.

PII: S1078-8174(10)00039-8

doi:10.1016/j.radi.2010.03.003

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