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Amaurosis Fugax in a Patient with a Left Ventricular Endocardial Pacemaker
Author(s) -
SCHIAVONE WILLIAM A.,
CASTLE LON W.,
SALCEDO ERNESTO,
GRAOR ROBERT
Publication year - 1984
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1984.tb04901.x
Subject(s) - medicine , amaurosis fugax , cardiology , catheter , bradycardia , radiology , stenosis , heart rate , blood pressure
A transvenous left ventricular endocardial pacemaker catheter is a potential source of systemic arterial embolization. The case of a woman who presented with left‐eye amaurosis fugax is reported. The patient had a history of contralateral carotid atherosclerosis; however, the digital subtraction angiography of the carotid arteries was not sufficiently abnormal to account for her present symptoms. The patient had a history of two myocardial infarctions and the tachycardia‐bradycardia syndrome for which she was treated with a demand ventricular pacemaker. The chest x‐ray and electrocardiogram suggested pacemaker catheter malposition. By M‐mode und two‐dimensional echocardiography, the catheter was shown to cross the atrial septum and the mitral valve to implant in the left ventricular endocardium. The approach to diagnosis and therapy that led to surgical removal of the pacing catheter is presented. The causes of the electrocardiographic right bundle branch block pattern in cardiac pacing and the usefulness of echocardiography in evaluating pacing catheters are discussed.