A Rare Cause of Cardiac Tamponade: Left Ventricular Pacemaker Malposition

The malpositioning of a pacemaker lead is an uncommon and under-reported complication of pacemaker/Automated Implantable Cardioverter-Defibrillator (AICD) placement. It can be associated with complications such as pericardial effusions and tamponade. We describe a case of an elderly woman who developed cardiac tamponade after inadvertent placement of a permanent pacing lead in the left ventricle. Following implantation of the permanent pacemaker, the patient developed dyspnea, and hypotension. Echocardiogram showed evidence of cardiac tamponade. Patient was successfully treated with pericardiocentesis and later on repositioning of the pacemaker lead in right ventricle.