Amaurosis Fugax in a Patient with a Left Ventricular Endocardial Pacemaker

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 ang...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 1984-03, Vol.7 (2), p.288-292
Main Authors: SCHIAVONE, WILLIAM A., CASTLE, LON W., SALCEDO, ERNESTO, GRAOR, ROBERT
Format: Article
Language:English
Subjects:
Aged
amaurosis fugax
Blindness - etiology
Bradycardia - therapy
Carotid Arteries - diagnostic imaging
Echocardiography
Electrocardiography
Embolism - etiology
endocardial pacemaker
Endocardium
Female
Heart Ventricles
Humans
Pacemaker, Artificial - adverse effects
patent foramen ovale
Radiography
Syndrome
Tachycardia - therapy
thromboembolism
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Summary: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.
ISSN:0147-8389
1540-8159
DOI:10.1111/j.1540-8159.1984.tb04901.x