Pacemaker lead entrapment complicating transcatheter closure of a patent foramen ovale.

T ranscatheter cardiovascular interventions are nowadays more frequently and safely performed, thus leading to populate the heart with medical devices. Here, we describe an unusual complication following percutaneous closure of a patent foramen ovale (PFO) with an atrial septal occluder. A 52-year-old woman with history of transient ischemic attack was found to have a PFO associated with an atrial septal aneurysm (an asterisk indicates the atrial septal aneurysm in diastole [Figure 1A] and systole [Figure 1B]; and color Doppler [Figure 1C]). Other comorbidities included sinus node dysfunction, paroxysmal atrial fibrillation, and status post dual-chamber pacemaker. She was then referred for percutaneous PFO closure with intracardiac echocardiography guidance (Figure 1D). After placement of a 30-mm Amplatzer septal occluder (AGA Medical Corporation, Golden Valley, Minnesota), it was noted that the right ventricular pacemaker lead was entrapped by the Amplatzer’s right atrial disk (Figures 1E and 1F). Initial failed attempts to release the lead with a 6-F pigtail catheter