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Cerebral Embolism Resulting from a Transvenous Pacemaker Catheter Inadvertently Placed in the Left Ventricle: A Report of Two Cases Confirmed by Echocardiography

Background: Transvenous pacemaker catheters may be placed unintentionally into the left ventricle. This can lead to thromboembolic complications. Methods and Results: We report two cases where pacemaker catheters placed unintentionally in the left ventricle via a patent foramen ovale resulted in cerebrovascular accidents. The malpositioned pacemaker catheters were demonstrated by transthoracic and transesophageal echocardiography. In both patients, no further embolic events have occurred after treatment, which in one case consisted of pacemaker catheter removal and in the other case, anticoagulation. Conclusion: Echocardiography can be useful to confirm inadvertent left ventricular pacemaker placement in patients with pacemakers who have cerebrovascular accidents.