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Paradoxic Embolism Due to Altered Hemodynamic Sequencing Following Transvenous Pacing
Author(s) -
SILKA MICHAEL J,
RICE MARY J
Publication year - 1991
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.1540-8159.1991.tb02820.x
Subject(s) - medicine , hemodynamics , cardiac pacing , cardiology
A young patient, who experienced a cerebral embolic event 30 days after transvenous pacemaker iead placement, is reported. This patient had previously been paced with an epicardial lead without evidence of right to left intracardiac shunt. However, hemodynamic evaluation post‐embolism demonstrated a marked temporal disparity of the pulmonary and systemic ventricles. This phasic divergence resulted in a brief reversal of right and left ventricular pressure ratios, and a paradoxic intracardiac shunt at a small ventricular septal defect. The potential for similar events in the presence of any defect of the atrial or ventricular septum mandates caution in the use of transvenous pacemaker leads in such patients.