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A frequently underdiagnosed complication of pacemaker and implantable cardioverter defibrillator lead implantation is the unintentional advancement of the leads into the systemic circulation. We report a case encountered in our clinic in a 70-year old man evaluated in a neighbouring clinic with symptoms of transient ischaemic attack with initially unclear aetiology. Posterior-anterior chest X-rays suggested that the lead was in the left heart. This finding was confirmed by transthoracic and transoesophageal echocardiography.

Transient ischaemic attack due to the lead of an implantable defibrillator in the left heart